Comparative Outcomes of Conventional TLIF With Posterior Decompression Surgery Versus Endoscopic Foraminotomy Surgery

Queen Savang Vadhana Memorial Hospital, Thailand

Status: Invitation-only

Conditions: Foraminal Stenosis

Treatments: Procedure: Endoscopic Foraminotomy Surgery

Study type: Interventional

Funder types: Other

Identifiers

NCT06685575

020/2567

Details and patient eligibility

About

Comparative Outcomes of Conventional Transforaminal Lumbar Interbody Fusion With Posterior Decompression Surgery Versus Endoscopic Foraminotomy Surgery in Stable Lumbar Foraminal Stenosis An Ambi-directional Cohort Study

Full description

Backgrounds :

Lumbar foraminal stenosis is a condition in which a spinal nerve is entrapped in a narrow lumbar foramen in degenerative lumbar spinal disorders. The gold standard treatment of this condition has not been proposed yet. Several different techniques for this problem has been described, including foraminotomy, facetectomy, partial pediculectomy, fusion, and distraction instrumentation.Nowadays, due to the great advancement of the technology in endoscopy expanded the indication of endoscopic decompression from the central canal to the extraforaminal zone, Which was difficult to gain access from the mere microscope.

Objectives :

To compare outcomes between posterior decompression With conventional transforaminal lumbar interbody fusion (TLIF) and full-endoscopic foraminoplasty (FELF) in stable lumbar foraminal Stenosis

Methods :

This is an ambi-directional cohort study, In retrospective part conducted from JAN2019-JAN2024 in Queen Savang Vadhana Memorial Hospital and the prospective part conducted from AUG2024 - JUNE 2025, Thailand. 60 patients presented with stable lumbar foraminal stenosis were divided into posterior decompression with conventional transforaminal lumbar interbody fusion (TLIF) group ( N=30) and full-endoscopic lumbar foraminoplasty (FELF) group (N=30). Demographic data and pre-perioperative parameters were analyzed. For TLIF group , Standard procedure had been performed.

Posterior decompression, pedicle screws and interbody cage ( Mont blanc, Spineway, France) insertion under image intensifier ( BV Pulsera,Philips).For endoscopic foraminoplasty , uniportal stenoscope ( Vertebris ,Riwospine ) was used to perform endoscopic decompressive surgery. Post-operative outcome , for instance , Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI) were recorded at preoperative, post-op day1, 3 month, 6 month and 1 year respectively. Other parameters such as estimated blood loss (EBL), length of hospital stay and post- operative complications were also recorded

Enrollment: 52 estimated patients

Sex: All

Ages: 30 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 30-80
• Persist radiculopathy and sciatica pain
• Patient that was diagnosed Stable lumbar foraminal stenosis
• Failed conservative for at least 6 months
• Patients who willing to join the study

Exclusion criteria

• Patients with unstable lumbar foraminal stenosis
• Patient with spine infection or tumor or fracture
• Patient with BMD less than -2.5 or osteopenia
• Patient with inflammatory joint diseases who on steroids
• Patient who has undergo with surgery that inserted metals in back
• Unable to answer questionnaires
• Cannot tolerate surgery due to severe medical comorbidities

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Sequential Assignment

Masking: None (Open label)

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52 participants in 2 patient groups

Conventional Transforaminal Lumbar Interbody Fusion With Posterior Decompression Surgery

No Intervention group

Description:

standard surgery for foraminal stenosis

Endoscopic Foraminotomy Surgery

Experimental group

Description:

The new type of surgery to treat lumbar foraminal stenosis which does not lead to instability of the spine

Treatment:

Procedure: Endoscopic Foraminotomy Surgery