Endoscopic Decompression, Foraminalplasty and Dorsal Rhizotomy for Foraminal Stenosis and Lumbar Spondylosis: A Hybrid Procedure in Lieu of Fusion
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Surgical treatment of chronic low back pain syndrome from an aging spine traditionally focuses on fusion as the ultimate surgical means to eliminate debilitating back pain and sciatica. A variety of painful degenerative conditions of the lumbar spine is treated surgically by translaminar decompression and fusion. Spine surgeons trained to perform fusions, with no training in endoscopic surgery are battling an economic crisis of escalating cost and affordability when fusion surgery is recommended for chronic back pain.
This is considered the ultimate treatment by surgeons favouring fusion as a means to treat perceived or actual instability and/or deformity supported by imaging studies. Aging, however can progress to stenosis, degenerative instability and deformity that are dependent on individual anatomic and physiologic differences. Disc degeneration, also affected by individual and facet sagittal alignment affects each person's response to normal progression of their aging process.