To the Editor: Derby et al (1) noted that in 2003 approximately half (14/29) of International Spinal Injection Society (ISIS) instructors and the majority (14/17) of poll respondents reported performing transforaminal epidural steroids injections. Do the authors have any data as to needle type (blunt vs sharp) used? If ISIS instructors persist in performing transforaminal injections with sharpt...

OBJECTIVES Transforaminal percutaneous endoscopic lumbar discectomy (PELD) for high-grade migrated disc herniation has been regarded as a challenging task, but because of the remarkable improvement in navigable instruments and advanced epiduroscopic technique, it can be used for the treatment of high- or very high-grade migrated disc herniation. The purpose of this study was to describe in deta...

INTRODUCTION Transforaminal lumbar interbody fusion is a popular procedure used to achieve spondylodesis in patients with degenerative lumbar spinal diseases. We present a rare case of a patient with a set screw fracture with cage dislocation after an open transforaminal lumbar interbody fusion procedure. To the best of our knowledge, this case is the first of its kind to be reported. CASE PR...

Removal of herniated disc materials based on an imaging only method may not relieve symptoms in many patients. Therefore, the aim of the present study was to develop a transforaminal endoscopic method of classifying the pathological type of lumber intervertebral disc herniation and to compare the outcomes of surgery based on the pathological type with those of conventional endoscopic disc remov...

STUDY DESIGN A prospective study randomized by patient choice from the private practice of a single physician affiliated with a major teaching hospital was conducted. OBJECTIVES To compare transforaminal epidural steroid injections with saline trigger-point injections used in the treatment of lumbosacral radiculopathy secondary to a herniated nucleus pulposus. SUMMARY OF BACKGROUND DATA Epi...

The utilization rate of transforaminal epidural steroid injections (TFESIs), an elective diagnostic and therapeutic spinal procedure, has risen dramatically over the past decade. In 2006 alone, greater than 300,000 thoracolumbar TFESIs were performed on Medicare beneficiaries. Despite the purported superiority of the transforaminal route, compared to other modes of epidural injection, TFESIs ar...

BACKGROUND Endoscopic discectomy is an ultra- minimally invasive outpatient surgical option for the treatment of lumbar herniated discs. The purpose of this study was to assess the benefit of tranforaminal versus interlaminar endoscopic discectomy in patients with single level Lumbar 5-Sacral 1(L5-S1) disc herniations and lumbar radiculopathy. METHODS After Institutional Review Board Approval...

OBJECTIVE To compare the interlaminar and transforaminal block techniques with regard to the state of pain and presence or absence of complications. METHOD This was a randomized double-blind prospective study of descriptive and comparative nature, on 40 patients of both sexes who presented lumbar sciatic pain due to central-lateral or foraminal disk hernias. The patients had failed to respond...

BACKGROUND We sought to construct a general methodology for objectively quantifying the learning curve associated with any surgical technique and to determine the number of cases needed to achieve a success rate of 90% for the technique of transforaminal endoscopic lumbar discectomy. To our knowledge, no other studies have observed the learning curve of endoscopic lumbar discectomy by transfora...