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ENDOSCOPIC FORAMINOPLASTY IN THE MANAGEMENT OF SPONDYLOLYTIC SPONDYLOLISTHESIS



Abstract

This study evaluates the results of Endoscopic Foraminoplasty on 30 consecutive patients followed for a minimum of 2 years.

The objective has been to assess the efficacy of endoscopic aware state pain source definition combined with endoscopic decompression of the foramen, mobilisation and neurolysis of the exiting and transiting nerves and ablation of osteophytes in patients with spondylolytic spondylolisthesis.

This prospective study involved Endoscopic Foraminoplasty performed on 16 males, and 14 females with an average age of 46 years (36–72 years). They were followed for an average period of 34 months (28–41 months).

One-hundred percent cohort integrity was maintained at the final follow up. Results were analysed using the percentage change in Oswestry Disability Index, and percentage change in visual analogue pain (VAP) scores. Using a percentage change in Oswestry Disability Index of 50 or more to determine good and excellent outcomes, 75% (22 out of 30) exceed this value with five (17%) having 100% benefit for the procedure.

These results indicate that Endoscopic Laser Foraminoplasty provides a minimalist means of exploring the extra-foraminal zone, the listhetic defect, the foramen and its contents, and the epidural space and performing decompression, discectomy, osteophytectomy, perineural neurolysis in patients with spondylolytic-spondylolisthes. Done in an aware state, it serves to identify and localise the source of pain generation.

The abstracts were prepared by Dr C Pither. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PN