1. 2021;24;E1119-E1128Assessment of Clinical Outcome of Lumbar Transforaminal Foraminoplasty in Patients with Lumbar Spinal Stenosis
   Retrospective Study
   Dong Eon Moon, MD, PhD, Hyun Min Bae, MD, Sung Hyun Lee, MD, PhD, Sung-Ha Hwang, MD, and Young-Kwan Moon, MD.

BACKGROUND: Lumbar spinal stenosis (LSS), a common spinal disorder that negatively affects quality of life, is a disabling condition accompanied by back pain, leg pain, and claudication. Lumbar foraminal stenosis (LFS) is often accompanied by lumbar central stenosis (LCS) and conservative treatment is often ineffective. A surgical approach, including a minimally invasive technique, is usually recommended for the conservative treatment of refractory conditions. To achieve effective decompression of LSS, a specially designed new instrument for lumbar transforaminal foraminoplasty (TFFP) can be considered before opting for surgical treatment.

OBJECTIVE: To evaluate the clinical outcomes and safety of TFFP with a specially designed instrument.

STUDY DESIGN: Retrospective design.

SETTING: This research was conducted in a hospital outpatient surgical center.

METHODS: The medical records of 112 patients who underwent TFFP from December 1, 2018 to January 1, 2020, were reviewed. Outcome measures were obtained using the numeric rating scale for pain (NRS pain), Oswestry Disability Index (ODI), and walking distance without pain for functional ability at preprocedure and 1, 3, and 6 months postprocedure. The clinical data and radiologic findings were analyzed to evaluate correlations between predictive factors and efficacy of TFFP.

RESULTS: Among 112 patients who underwent TFFP, 110 were accessed and analyzed. The percentage of successful responders was 59.1%, 73.6%, and 74.5 % of 110 patients at one, 3, and 6 months, respectively. The NRS pain score, ODI, and duration of walking without radicular pain were improved significantly at the one-, 3-, and 6-month follow-up periods (all P < 0.001). No serious adverse events occurred during this study.

LIMITATIONS: The limitations of this study include the possibility of bias due to nonrandomized patient selection.

CONCLUSION: TFFP using the Foramoon® device (Mcarekorea, Seongnam-si, Gyeonggi-do, Republic of Korea) appeared to be effective for managing patients with LFS and LCS, who were refractory to conservative care.

KEY WORDS: Lumbar spinal stenosis, lumbar foraminal stenosis, lumbar central stenosis, transforaminal foraminoplasty, ligament flavum, transverse ligament, neural compression, radicular pain