Introduction:

Lumbar radiculopathy is commonly associated with lumbar disc herniation. Epiduroscopy is a method that can be applied in patients who do not benefit from conservative treatment by entering the epidural space with a fiber optic endoscope through the sacral hiatus. We present trans-sacral epiduroscopic foraminoplasty (TSEF) procedure with the Fogarty balloon catheter.

Methods:

We collected retrospectively 43 patients who had undergone TSEF between 2013 and 2016. Pain intensity was recorded with visual analogue scale (VAS), and functional outcome was recorded with Oswestry Disability Index (ODI) at preoperative, postoperative 1st, 6th and 12th month follow-ups. Surgery satisfaction was evaluated with Macnab criteria at 1st, 6th and 12th month follow-ups.

Results:

There were 27 female (62.8%) and 16 male (37.2%) patients. The mean age of the patients were 70.04 ± 7.78 years. The mean follow-up period was 15.25 ± 1.97 months. Preoperative VAS score averages were 6.44 ± 0.88, decreased to 1.72 ± 1.34, 3.21 ± 0.91 and 3.41 ± 1.17 in postoperative 1st, 6th and 12th month respectively (p<0.0001). The preoperative ODI scores decreased from 71.52 ± 6.72 to 19.31 ± 5.49, 27.61 ± 5.37, 31.31 ± 7.91 postoperative 1st, 6th and 12th month respectively (p <0.0001). The surgical satisfaction in terms of Macnab criteria were found at 12th month follow up as 60% excellent, 35% good and 5% fair results.

Conclusion:

The TSEF procedure is a minimally invasive surgical technique that is easily performed to the patients who are resistant to lumbar radiculopathy, especially those who do not respond to epidural steroid injections, with good long-term results.

Keywords: Lumbar radiculopathy, lumbar disc herniation, trans-sacral epiduroscopic foraminoplasty