Partial Facetectomy for Lumbar Foraminal Stenosis

Background. Several different techniques exist to address the pain and disability caused by isolated nerve root impingement. Failure to adequately decompress the lumbar foramen may lead to failed back surgery syndrome. However, aggressive treatment often causes spinal instability or may require fusi...

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Main Authors: Kevin Kang, Juan Carlos Rodriguez-Olaverri, Frank Schwab, Jenifer Hashem, Afshin Razi, Jean Pierre Farcy
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Advances in Orthopedics
Online Access:http://dx.doi.org/10.1155/2014/534658
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author Kevin Kang
Juan Carlos Rodriguez-Olaverri
Frank Schwab
Jenifer Hashem
Afshin Razi
Jean Pierre Farcy
author_facet Kevin Kang
Juan Carlos Rodriguez-Olaverri
Frank Schwab
Jenifer Hashem
Afshin Razi
Jean Pierre Farcy
author_sort Kevin Kang
collection DOAJ
description Background. Several different techniques exist to address the pain and disability caused by isolated nerve root impingement. Failure to adequately decompress the lumbar foramen may lead to failed back surgery syndrome. However, aggressive treatment often causes spinal instability or may require fusion for satisfactory results. We describe a novel technique for decompression of the lumbar nerve root and demonstrate its effectiveness in relief of radicular symptoms. Methods. Partial facetectomy was performed by removal of the medial portion of the superior facet in patients with lumbar foraminal stenosis. 47 patients underwent the procedure from 2001 to 2010. Those who demonstrated neurogenic claudication without spinal instability or central canal stenosis and failed conservative management were eligible for the procedure. Functional level was recorded for each patient. These patients were followed for an average of 3.9 years to evaluate outcomes. Results. 27 of 47 patients (57%) reported no back pain and no functional limitations. Eight of 47 patients (17%) reported moderate pain, but had no limitations. Six of 47 patients (13%) continued to experience degenerative symptoms. Five of 47 patients (11%) required additional surgery. Conclusions. Partial facetectomy is an effective means to decompress the lumbar nerve root foramen without causing spinal instability.
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spelling doaj-art-5ce3dbc3a6304ade923b2b39d6a8e9c92025-02-03T01:02:36ZengWileyAdvances in Orthopedics2090-34642090-34722014-01-01201410.1155/2014/534658534658Partial Facetectomy for Lumbar Foraminal StenosisKevin Kang0Juan Carlos Rodriguez-Olaverri1Frank Schwab2Jenifer Hashem3Afshin Razi4Jean Pierre Farcy5Maimonides Medical Center, Department of Orthopaedic Surgery, 927 49th Street, Brooklyn, NY 11219, USAMaimonides Medical Center, Department of Orthopaedic Surgery, 927 49th Street, Brooklyn, NY 11219, USANew York University Hospital for Joint Diseases, New York, NY 10016, USAMaimonides Medical Center, Department of Orthopaedic Surgery, 927 49th Street, Brooklyn, NY 11219, USAMaimonides Medical Center, Department of Orthopaedic Surgery, 927 49th Street, Brooklyn, NY 11219, USAMaimonides Medical Center, Department of Orthopaedic Surgery, 927 49th Street, Brooklyn, NY 11219, USABackground. Several different techniques exist to address the pain and disability caused by isolated nerve root impingement. Failure to adequately decompress the lumbar foramen may lead to failed back surgery syndrome. However, aggressive treatment often causes spinal instability or may require fusion for satisfactory results. We describe a novel technique for decompression of the lumbar nerve root and demonstrate its effectiveness in relief of radicular symptoms. Methods. Partial facetectomy was performed by removal of the medial portion of the superior facet in patients with lumbar foraminal stenosis. 47 patients underwent the procedure from 2001 to 2010. Those who demonstrated neurogenic claudication without spinal instability or central canal stenosis and failed conservative management were eligible for the procedure. Functional level was recorded for each patient. These patients were followed for an average of 3.9 years to evaluate outcomes. Results. 27 of 47 patients (57%) reported no back pain and no functional limitations. Eight of 47 patients (17%) reported moderate pain, but had no limitations. Six of 47 patients (13%) continued to experience degenerative symptoms. Five of 47 patients (11%) required additional surgery. Conclusions. Partial facetectomy is an effective means to decompress the lumbar nerve root foramen without causing spinal instability.http://dx.doi.org/10.1155/2014/534658
spellingShingle Kevin Kang
Juan Carlos Rodriguez-Olaverri
Frank Schwab
Jenifer Hashem
Afshin Razi
Jean Pierre Farcy
Partial Facetectomy for Lumbar Foraminal Stenosis
Advances in Orthopedics
title Partial Facetectomy for Lumbar Foraminal Stenosis
title_full Partial Facetectomy for Lumbar Foraminal Stenosis
title_fullStr Partial Facetectomy for Lumbar Foraminal Stenosis
title_full_unstemmed Partial Facetectomy for Lumbar Foraminal Stenosis
title_short Partial Facetectomy for Lumbar Foraminal Stenosis
title_sort partial facetectomy for lumbar foraminal stenosis
url http://dx.doi.org/10.1155/2014/534658
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