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Full-endoscopic spine surgery for radiculopathy after osteoporotic vertebral compression fractures: a case report

Case Reports


doi: 10.21037/jss.2019.10.11.

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Case Reports

Giby Abraham Cherry Philips et al.


J Spine Surg.


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Abstract

Full-endoscopic spine surgery (FESS) is a suitable treatment for lumbar disc herniation (LDH) and foraminal stenosis. Here, we describe the usefulness of FESS for treating radiculopathy after osteoporotic vertebral compression fractures (OVCFs). Between October 2018 and April 2019, three female patients (mean age, 81.7 years) with radiculopathy after OVCFs underwent FESS. Decompression of the corresponding nerve root was achieved using several FESS techniques, including foraminoplasty, discectomy, and removal of osteophyte or cement leakage. The mean operative time was 60.7 min. Preoperative and postoperative statuses were evaluated using numerical rating scale (NRS) scores. The mean pre- and postoperative NRS scores were 9 and 2.3, respectively. We observed no postoperative complications. Our results demonstrate that FESS is a safe and effective minimally invasive treatment for radiculopathy after OVCFs, with the potential to be an alternative to vertebroplasty, balloon kyphoplasty (BKP), or lumbar interbody fusion.


Keywords:

Full-endoscopic spine surgery (FESS); foraminoplasty; minimally invasive; osteoporotic vertebral compression fractures (OVCFs); radiculopathy.

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jss.2019.10.11). The series “Full-endoscopic Spine Surgery” was commissioned by the editorial office without any funding or sponsorship. HK served as the unpaid Guest Editor of the series and serves as an unpaid editorial member of Journal of Spine Surgery from October 2018 to October 2020. The other authors have no other conflicts of interest to declare.

Figures


Figure 1

Figure 1

Computed tomography findings of case 1 (A,B), case 2 (C,D), case 3 (E,F). Preoperative (A,C,E) and postoperative (B,D,F) sagittal (left) and axial (right) CT images are shown. The yellow arrows indicate the areas of foraminoplasty, while the green arrows indicate the areas of osteophyte removal located along a vertebral endplate. CT, computed tomography.


Figure 2

Figure 2

MRI, intraoperative endoscopy, and CT findings of case 3. Preoperative (A) and postoperative (B) sagittal (left) and axial (right) T2-weighted MRI showing the enlarged foramen (yellow arrows) and the area after removing vertebral osteophytes (green arrows) (B); (C) after removal of the SAP, a protruded white disc material appeared at the center of the endoscopic view (left). Subsequent removal of the disc material created a large cavity at the intervertebral disc space that leaked PMMA (blue arrow) at the bottom of the cavity; (D) preoperative (left) and postoperative (right) sagittal CT showing leaked PMMA at the intervertebral disc space (blue arrow). Note that the leaked PMMA disappeared after the full-endoscopic spine surgery. SAP, superior articular process; Preop, pre-operation; Postop, post-operation; MRI, magnetic resonance imaging; CT, computed tomography; PMMA, polymethylmethacrylate.

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