Teaching Video: Foraminal Osteophytosis – Indication for Trans-foraminal Decompression

Symptomatic foraminal osteophytes are difficult to diagnose due to its insidious onset and lack of acute symptoms. A diagnosis of symptomatic osteophytosis is difficult for traditional spine surgeons to treat. However, endoscopic decompression can easily decompress the osteophyte as shown in the procedure demonstrated here.

This 71 year old female from Chicago was referred by her spine surgeon after several spine surgeons in Chicago did not have any specific recommendations for her chronic sciatica from a foraminal osteophyte at a degenerative disc level.

She had an obvious osteophyte that can be asymptomatic in many patients and usually considered a condition of normal aging. She only had pain, and no obvious evidence of radiculopathy except for a mildly depressed knee reflex and chronic intermittent pain that progressed each year.

Finally, her friend and orthopedic spine surgeon who trained with me, asked her to contact me to see if anything could be done. I determined that she had a foraminal space occupying lesion that was causing her pain and provided a transforaminal epidural therapeutic injection that gave her complete relief for a short period of time.

She came from out of town and did not want to wait to see if the steroid took effect later. Following her surgery, she was immediately “pain free”.

This illustrates an unknown indication by traditional spine surgeons who, after physical therapy and/or pain management, had no other recommendations.

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