J Am Acad Orthop Surg Glob Res Rev. 2025 Dec 16;9(12). doi: 10.5435/JAAOSGlobal-D-25-00057. eCollection 2025 Dec 1.
ABSTRACT
INTRODUCTION: Intermediate outcomes of foraminal decompression (FD) have not been reported using biportal endoscopic assistance (biportal endoscopic-foraminal decompression [BE-FD]). The goal of this study was to evaluate the clinical and radiologic outcomes of FD and analyzing risk factors for less successful outcomes.
METHODS: Patients who underwent BE-FD for single-level lumbar foraminal stenosis were enrolled. Demographic and radiographic parameters were collected. For clinical evaluation, Oswestry Disability Index and Visual Analog Scale (VAS) for back and leg pain were used. Patients were divided into group A with excellent and group B with less satisfactory results.
RESULTS: A total of 141 patients were selected for this study. Ninety-eight of 141 (69.5%) had excellent outcomes. Group B had improvement in Oswestry Disability Index and VAS leg but less than group A. VAS back did not differ between the groups. Fourteen of patients (9.9%) required revision fusion surgery. In univariate analysis, smaller preoperative intervertebral disk height (IVD), smaller preoperative foraminal height (FH), and more disk wedging (DW) were associated with poorer outcomes. Larger change in IVD, FH, and DW was also associated with suboptimal outcomes and lower level of surgery. In multivariate analysis, level of surgery, preoperative DW, and change in IVD, FH, and DW were notable.
CONCLUSION: BE-FD was able to provide notable symptom improvement; only 9.9% required revision surgery. Lumbar foraminal stenosis pathology in the lower lumbar, less preoperative IVD and FH, and higher disk wedge angle should be taken care with caution when FD is considered because clinical improvement may be less than those patients without those risk factors.
PMID:41411496 | DOI:10.5435/JAAOSGlobal-D-25-00057
