Full-Endoscopic Paraspinal Foraminotomy for Lumbar Foraminal Stenosis
10.21182/jmisst.2025.02733
- Author:
Young Hwan KIM
1
;
Jae Ho KIM
;
Pius KIM
;
Chang Il JU
;
Jong Hun SEO
Author Information
1. Department of Neurosurgery, College of Medicine, Chosun University, Gwangju, Korea
- Publication Type:Video
- From:
Journal of Minimally Invasive Spine Surgery and Technique
2026;11(1):169-176
- CountryRepublic of Korea
- Language:English
-
Abstract:
Transforaminal endoscopic lumbar foraminotomy (TELF) is widely performed as a full-endoscopic surgical procedure for the treatment of lumbar foraminal stenosis. The technique involves the use of a small-caliber endoscopic system introduced through Kambin triangle to accomplish the primary surgical steps. However, anatomical barriers are frequently encountered in the lower lumbar segments, particularly at L4–5 and L5–S1, which may limit the feasibility of the transforaminal approach. Although various advanced transforaminal techniques have been developed to overcome these anatomical barriers, these techniques often make the procedure more technically demanding and may prolong operative time. In this video presentation, we report 2 cases in which a full-endoscopic paraspinal lumbar foraminotomy was performed to achieve adequate decompression of the exiting nerve root (ENR) without being constrained by these anatomical limitations. We also outline the procedural details and technical characteristics of this approach. Both patients presented with lumbar foraminal stenosis at the L5–S1 level, where anatomical barriers such as a high iliac crest, large transverse process, and sacral ala were present. A full-endoscopic paraspinal foraminotomy was performed at this level using a large-caliber endoscopic system, allowing sufficient decompression of the ENR and resulting in marked relief of radicular leg pain. We report a surgical procedure for full-endoscopic paraspinal lumbar foraminotomy using a large-caliber endoscopic system that permits the use of instruments of various sizes and configurations. When applied in appropriate clinical scenarios, this technique may facilitate more convenient and expedited decompression of the ENR.
