Even for conditions where severe deformity and instability dictates fusion as the optimal traditional treatment, there are individuals who get reasonable results with non-surgical or minimally invasive decompression, especially transforaminal endoscopic decompression and ablation. These procedures provide enough pain relief that the patients who opt for these MIS methods are very satisfied with the results targeting the pain generator rather than the deformity.
The Grade II Spondylolisthesis video illustrates the efficacy of the transforaminal endoscopic approach for decompression of the axilla of the exiting nerve and ablation of the branches of the dorsal ramus innervation the facet joints as a viable method for pain relief. It is performed in an ASC, which affords even greater cost savings that is being recognized by CMS and payers. Informed spine surgeons are beginning to refer their patients with this type of deformity due to the good results being obtained.
The Endoscopic Decompression for Scoliosis and Stenosis video is an example of a stenotic condition best decompressed with an endoscopic transforaminally foraminal decompression. This 53 year old female was referred by spine surgeon B. Tontz for endoscopic decompression for scoliosis and stenosis. The patient’s pre-op sciatica resolved immediately in the recovery room and at follow-up. Fusion required with open surgery may still be needed, but the patient is happy for further pain relief post-op. The endoscopic decompression was effective.