8. Foraminal Stenosis

Degenerative loss of intervertebral disc height, facet joint hypertrophy, and thickening of the ligamentum flavum may narrow the intervertebral foramen. Compression of the exiting nerve root in this region may cause radiculopathy.

Surgical treatment of lumbar foraminal stenosis may involve decompression alone or decompression with additional stabilization, depending on the anatomy, segmental stability, and required extent of resection. Endoscopic foraminal decompression can relieve nerve root compression without fusion if the approach and required extent of resection allow segmental stability to be preserved.

In this chapter, I describe a posterolateral approach for foraminal decompression using biportal endoscopic spine surgery (BESS/UBE). I select the approach according to the location of compression and the individual anatomy.

References

1. Kim JE, Choi DJ, Park EJ. Clinical and Radiological Outcomes of Foraminal Decompression Using Unilateral Biportal Endoscopic Spine Surgery for Lumbar Foraminal Stenosis. Clin Orthop Surg. 2018;10(4):439–447. DOI: 10.4055/cios.2018.10.4.439.

2. Bui AT, Trinh GM, Wu MH, Hoang TT, Hu MH, Pao JL. Indications for and Outcomes of Three Unilateral Biportal Endoscopic Approaches for the Decompression of Degenerative Lumbar Spinal Stenosis: A Systematic Review. Diagnostics. 2023;13(6):1092. DOI: 10.3390/diagnostics13061092.

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