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ENDOSCOPIC FORAMINAL SURGERY IN THE MANAGEMENT OF SPONDYLOLYTIC SPONDYLOLISTHESIS



Abstract

Objectives: To assess the efficacy and outcome 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 followed for a minimum of two years.

Design: This prospective study determined the outcome of endoscopic foraminal decompression in symptomatic spondylolytic-spondylolisthesis.

Subjects: Sixteen males, and fourteen females with an average age of 46 years

Outcome measures: Results were analysed using the percentage change in Oswestry Disability Index, and percentage change in visual analogue pain (VAP) scores.

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

Conclusion: These results indicate that Endoscopic Laser Foraminoplasty provides a minimalist means of exploring the extraforaminal zone, the lytic defect, the foramen, 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.

Abstracts prepared by Mr. A. J. Stirling, FRCS, and Miss A. Weaver. Correspondence should be addressed to Miss A. Weaver at the Research and Teaching Centre, Royal Orthopaedic Hospital, Northfield, Birmingham, B31 2AP, UK

BritSpine 2002, the second combined meeting of the British Association of Spinal Surgeons, the British Cervical Spine Society, The British Scoliosis Society and the Society for Back Pain Research, took place at the International Convention Centre in Birmingham UK between 27th February and 1st March 2002. The following presentations and posters were given and displayed.