Short-term Clinical and Radiographic Outcomes of Transforaminal Full-endoscopic Pars Crisscross Decompression of the Exiting Nerve Root under Local Anesthesia in Adult Isthmic Spondylolisthesis

In adult isthmic spondylolysis/spondylolisthesis, a fibrocartilaginous mass, ragged edge, and decrease in disk height cause radiculopathy with intervertebral foraminal stenosis. There are few reports on the outcomes of full-endoscopic spine surgery for isthmic spondylolisthesis because of difficulty...

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Main Authors: Yutaro KANDA, Fumiaki MAKIYAMA, Ryota MIO, Kozaburo MIZUTANI, Masashi KUMON, Saori SOEDA, Masatoshi MORIMOTO, Fumitake TEZUKA, Kazuta YAMASHITA, Koichi SAIRYO
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Language:English
Published: The Japan Neurosurgical Society 2025-06-01
Series:Neurologia Medico-Chirurgica
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Online Access:https://www.jstage.jst.go.jp/article/nmc/65/6/65_2024-0279/_pdf/-char/en
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author Yutaro KANDA
Fumiaki MAKIYAMA
Ryota MIO
Kozaburo MIZUTANI
Masashi KUMON
Saori SOEDA
Masatoshi MORIMOTO
Fumitake TEZUKA
Kazuta YAMASHITA
Koichi SAIRYO
author_facet Yutaro KANDA
Fumiaki MAKIYAMA
Ryota MIO
Kozaburo MIZUTANI
Masashi KUMON
Saori SOEDA
Masatoshi MORIMOTO
Fumitake TEZUKA
Kazuta YAMASHITA
Koichi SAIRYO
author_sort Yutaro KANDA
collection DOAJ
description In adult isthmic spondylolysis/spondylolisthesis, a fibrocartilaginous mass, ragged edge, and decrease in disk height cause radiculopathy with intervertebral foraminal stenosis. There are few reports on the outcomes of full-endoscopic spine surgery for isthmic spondylolisthesis because of difficulty in the ragged edge resection. This study evaluated the short-term outcomes of our original full-endoscopic spine surgery technique in patients with isthmic spondylolisthesis with a focus on the “pars crisscross.” An important landmark, the pars crisscross consist of the superior articular process at S1, floating lamina, inferior articular process at L4, and pars ragged edge. The exiting nerve root can only be decompressed by complete resection of the ragged edge after confirmation of the pars crisscross. This case series includes 6 patients (mean age 63.2 ± 14.3 years) who underwent full-endoscopic spine surgery under local anesthesia for radiculopathy. The leg pain improved immediately after surgery in all patients and the mean visual analog scale score improved from 8.2 ± 1.3 preoperatively to 1.2 ± 1.1 at 2 weeks postoperatively. The neuroforaminal area at the inlet and center expanded dramatically from 184 ± 41 mm2 and 192 ± 45 mm2, respectively, before surgery to 340 ± 55 mm2 and 338 ± 80 mm2 postoperatively. No patient experienced a recurrence of leg pain, aggravation of low back pain, or spinal instability during the 3 months after surgery. full-endoscopic spine surgery pars crisscross decompression had excellent short-term clinical and radiographic outcomes. Patients who are unsuitable for general anesthesia and instrumentation surgery could be candidates for this procedure.
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spelling doaj-art-6a9aa49d1be84bb4b885db6bb6c3d2872025-08-20T02:44:34ZengThe Japan Neurosurgical SocietyNeurologia Medico-Chirurgica1349-80292025-06-0165627127710.2176/jns-nmc.2024-02792024-0279Short-term Clinical and Radiographic Outcomes of Transforaminal Full-endoscopic Pars Crisscross Decompression of the Exiting Nerve Root under Local Anesthesia in Adult Isthmic SpondylolisthesisYutaro KANDA0Fumiaki MAKIYAMA1Ryota MIO2Kozaburo MIZUTANI3Masashi KUMON4Saori SOEDA5Masatoshi MORIMOTO6Fumitake TEZUKA7Kazuta YAMASHITA8Koichi SAIRYO9Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate SchoolDepartment of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate SchoolDepartment of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate SchoolDepartment of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate SchoolDepartment of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate SchoolDepartment of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate SchoolDepartment of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate SchoolDepartment of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate SchoolDepartment of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate SchoolDepartment of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate SchoolIn adult isthmic spondylolysis/spondylolisthesis, a fibrocartilaginous mass, ragged edge, and decrease in disk height cause radiculopathy with intervertebral foraminal stenosis. There are few reports on the outcomes of full-endoscopic spine surgery for isthmic spondylolisthesis because of difficulty in the ragged edge resection. This study evaluated the short-term outcomes of our original full-endoscopic spine surgery technique in patients with isthmic spondylolisthesis with a focus on the “pars crisscross.” An important landmark, the pars crisscross consist of the superior articular process at S1, floating lamina, inferior articular process at L4, and pars ragged edge. The exiting nerve root can only be decompressed by complete resection of the ragged edge after confirmation of the pars crisscross. This case series includes 6 patients (mean age 63.2 ± 14.3 years) who underwent full-endoscopic spine surgery under local anesthesia for radiculopathy. The leg pain improved immediately after surgery in all patients and the mean visual analog scale score improved from 8.2 ± 1.3 preoperatively to 1.2 ± 1.1 at 2 weeks postoperatively. The neuroforaminal area at the inlet and center expanded dramatically from 184 ± 41 mm2 and 192 ± 45 mm2, respectively, before surgery to 340 ± 55 mm2 and 338 ± 80 mm2 postoperatively. No patient experienced a recurrence of leg pain, aggravation of low back pain, or spinal instability during the 3 months after surgery. full-endoscopic spine surgery pars crisscross decompression had excellent short-term clinical and radiographic outcomes. Patients who are unsuitable for general anesthesia and instrumentation surgery could be candidates for this procedure.https://www.jstage.jst.go.jp/article/nmc/65/6/65_2024-0279/_pdf/-char/enfull-endoscopic spine surgeryadult isthmic spondylolysisspondylolisthesislumbar spineforaminal stenosis
spellingShingle Yutaro KANDA
Fumiaki MAKIYAMA
Ryota MIO
Kozaburo MIZUTANI
Masashi KUMON
Saori SOEDA
Masatoshi MORIMOTO
Fumitake TEZUKA
Kazuta YAMASHITA
Koichi SAIRYO
Short-term Clinical and Radiographic Outcomes of Transforaminal Full-endoscopic Pars Crisscross Decompression of the Exiting Nerve Root under Local Anesthesia in Adult Isthmic Spondylolisthesis
Neurologia Medico-Chirurgica
full-endoscopic spine surgery
adult isthmic spondylolysis
spondylolisthesis
lumbar spine
foraminal stenosis
title Short-term Clinical and Radiographic Outcomes of Transforaminal Full-endoscopic Pars Crisscross Decompression of the Exiting Nerve Root under Local Anesthesia in Adult Isthmic Spondylolisthesis
title_full Short-term Clinical and Radiographic Outcomes of Transforaminal Full-endoscopic Pars Crisscross Decompression of the Exiting Nerve Root under Local Anesthesia in Adult Isthmic Spondylolisthesis
title_fullStr Short-term Clinical and Radiographic Outcomes of Transforaminal Full-endoscopic Pars Crisscross Decompression of the Exiting Nerve Root under Local Anesthesia in Adult Isthmic Spondylolisthesis
title_full_unstemmed Short-term Clinical and Radiographic Outcomes of Transforaminal Full-endoscopic Pars Crisscross Decompression of the Exiting Nerve Root under Local Anesthesia in Adult Isthmic Spondylolisthesis
title_short Short-term Clinical and Radiographic Outcomes of Transforaminal Full-endoscopic Pars Crisscross Decompression of the Exiting Nerve Root under Local Anesthesia in Adult Isthmic Spondylolisthesis
title_sort short term clinical and radiographic outcomes of transforaminal full endoscopic pars crisscross decompression of the exiting nerve root under local anesthesia in adult isthmic spondylolisthesis
topic full-endoscopic spine surgery
adult isthmic spondylolysis
spondylolisthesis
lumbar spine
foraminal stenosis
url https://www.jstage.jst.go.jp/article/nmc/65/6/65_2024-0279/_pdf/-char/en
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