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Endoscopic Foraminoplasty Surgery in Arizona

Endoscopic foraminoplasty is the least invasive spine surgery that effectively treats foraminal stenosis or narrowing and compression of the exiting nerve.

Foraminal stenosis patients usually suffer from low back pain, sciatica, and leg pain. Stenosis can be caused by a bone spur, herniated disc, or enlarged facet joints in the spinal canal pinching the exiting nerve.

Endoscopic foraminoplasty surgery is also an effective treatment option for failed back surgery patients suffering from leg or back pain. Failed back syndrome is often related to residual pressure from bone spurs on the spinal nerve. Your previous surgery may not have relieved all the pressure on the exiting nerve enough to provide adequate pain relief.

Traditional midline (middle of your back) surgical access sometimes has difficulty accessing the lateral recess, leading to failed back surgery. The endoscopic foraminoplasty surgical approach starting from the patient’s side instead of the midline more effectively targets the lateral recess.

Illustration of side firing laser ablating bone under the superior articular process
FIGURE 1: ILLUSTRATION OF SIDE FIRING LASER ABLATING BONE UNDER THE SUPERIOR ARTICULAR PROCESS1

How is Endoscopic Foraminoplasty Performed?

This innovative approach avoids and preserves the significant muscles of the back while also affording the surgeon an excellent view and working access to the foramen. Unlike many spine surgeons, an endoscopic spine surgeon can treat some patients suffering from low back or leg pain without a spinal fusion.
MRI Demonstrates Cephalad Extrusion of HNP

Endoscopic Foraminoplasty

Through a ¼ inch incision in your back, our surgeon utilizes an endoscope attached to an HD camera to optimize their anatomical field of vision.

The surgeon then uses micro-instruments, a motorized burr, Kerrison rongeur, and a laser to precisely visualize and decompress the exiting nerve.

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Figure 2: Endoscopic foraminal decompression of facet joint that is compressing an exiting nerve.2

Figure 3: Endoscopic foraminoplasty allows a scope, canula, and instruments access to the lateral recess and epidural space. The Endoscopic surgeon can selectively explore and decompress the herniated disc and bone spurs related to failed back surgery syndrome.3

Figure 4: Illustration of surgical foraminoplasty3

Sources
 1. Yeung, AT., & Yeung, CA. Endoscopic Discectomy and Foraminal Decompression. In: Slipman CW, Derby R, Simeone FA, Mayer TG (Eds). Interventional Spine: An Algorithmic Approach. Philadelphia: Elsevier Health Sciences; 2008.pp1406-13.
2. Yeung A. T. (2007). The Evolution and Advancement of Endoscopic Foraminal Surgery: One Surgeon’s Experience Incorporating Adjunctive Techologies. SAS journal, 1(3), 108–117. https://doi.org/10.1016/SASJ-2006-0014-RR
3. Yeung AT (2018) The Yeung Percutaneous Endoscopic Lumbar Decompressive Technique (YESSTM). J Spine 7: 408. doi: 10.4172/2165-7939.1000408

What Conditions Does Endoscopic Foraminoplasty Treat?

What are the Advantages of a Lumbar Endoscopic Foraminoplasty versus a Minimally Invasive Lumbar Spinal Fusion?

There are many advantages to having an endoscopic foraminoplasty instead of an MIS spine fusion. The patient outcomes for a spine surgery related to low back and leg pain have significantly evolved over the past twenty years.

With the evolution of endoscopic spine surgery, pioneered at DISC, spine surgeons no longer need to make large skin incisions to expose the spine to operate.

For example, the endoscopic foraminoplasty utilizes a ¼-inch incision far smaller than the MIS fusion, which uses two to four 1-inch incisions. Smaller skin incisions in spine surgery have less post-operative pain, minimal or no need for narcotic medication, and faster recovery times.

In addition, unlike many spine surgeons, an endoscopic spine surgeon can treat some patients suffering from low back or leg pain without a spinal fusion.

At DISC, our philosophy is to utilize the least invasive yet most effective treatments available to restore, revitalize, and rejuvenate our patients’ active lifestyles.

To our patients, the most crucial advantage to an endoscopic procedure besides pain relief is returning to work and life as soon as possible.

The return to work is only 1-2 weeks for an endoscopic surgery versus 8-12 weeks for a lumbar spine fusion.

Benefits of Endoscopic Foraminoplasty:

  • HD Endoscope Provides the Spine Surgeon a Superior View of the Spine
  • Spine Fusion Alternative
  • Muscle and Spine Preservation
  • 1/4-Inch Incision Smallest in Spine Surgery
  • Reduced Scarring Internally and on the Skin 
  • Less Blood Loss
  • Local Anesthesia and Mild Sedation Reduces the Associated Risk from General Anesthesia
  • Outpatient Surgery – Patients Go Home in Two Hours After Surgery Reduced Risk of Infection
What is the Recovery of an Endoscopic Foraminoplasty?

The short answer is one to two weeks of recovery for most patients after an endoscopic foraminoplasty. After quick one-hour surgery, patients will recover for about an hour, then dress and depart the surgical center.

Each person’s recovery time depends on how well your body responds to the surgery. In our experience over the past 20 years and over 10,000 successful cases, many patients feel immediate back and leg pain relief after surgery. Our patients typically go back to administrative work within one week.

We advise our patients to follow our surgeon’s post-operative instructions carefully. Any physical or heavy lifting should be avoided until cleared by your spine surgeon.

Just because you feel better does not mean you are completely healed or ready for physical work or play.

Am I a Candidate?

You may be a candidate for endoscopic foraminoplasty if you:

  • Have low back or leg pain for more than six weeks
  • Have radiating, one-sided leg pain
  • Have been offered spine fusion by another spine surgeon, and this does not fit your active lifestyle
  • Failed back surgery
  • Have been told you have lateral recess stenosis
  • Have temporary relief of symptoms from a transforaminal epidural steroid injection

Due to evolving physicians treatment methodology, certain degenerative conditions, if not too severe, can be helped, but only after individual evaluation of each patient and their response to evocative discography, and other diagnostic injections can our surgeons tell if the endoscopic procedure is recommended for you.

If, after reading the above, you believe endoscopic foraminoplasty may help you, feel free to contact us for an appointment. Out-of-state and interested in a second opinion? Please fill out our DISC Out of State Consultation Request Form and a member of the DISC staff will reach out to you immediately.

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1635 E. Myrtle • Suite 400 • Phoenix, AZ 85020
Ph: 602-944-2900 • Fax: 602-944-0064

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