transForaMinal endosCopiC ForaMinotoMy in luMbar spinal stenosis

Congenital Lumbar spinal stenosis (LSS) defined first by Dr. Sarpyener in 1940’s17, and degenerative LSS was defined by Verbiest in 1950’s.19 Degenerative LSS can be classified as simple or complex LSS, depending on the presence or absence of attendant pathologies. LSS can also be classified on axial plane as central, lateral, or foraminal. LSS may result inneurogenic claucation or radiculopathy depending on localization of stenosis. % 8-10 of LSS is located at lateral or foramen levels, and cause radiculopathy.12,16,18 There is no complete consensus about the treatment of LSS. Although, the best alternative is applying surgical intervention in case of failing the conservative treatment, standard surgical interventions include total laminectomy, hemipartial laminectomy, flavectomy bilateral decompression by unilateral approach. At the same time in recent years, microendoscopic decompressions, which made from midline and endoscopic decompression made by posterolateral and transforaminal approaches.1-3,8.10,11,14,15 Basically, posterolateral endoscopic approach has been started for discectomy. Kambin and Gellman 7 in 1973, Hijikata 5 in 1975 has been a Pioneer in the field of percutaneous discectomy by the way of posterolateral approach. In time, lots of Lumbar discectomy and foraminotomy methods were developed depending on the development of endoscopic systems. In later years, using Holmium YAG laser has provided ablation of soft tissue and osseous tissue. 10,11,20,21 Endoscopic laser applications and also foraminotomy applications have increased in last 10 years. In 2003, Hoogland6 and Ahn1 reported the foraminotomy technique by using reamer (rasp) by approach posterolateral. Recently foraminotomy using drill has been popular.