Clinical results of intrapedicular partial pediculectomy for lumbar foraminal stenosis

Design: A retrospective case study of the use of intrapedicular partial pediculectomy (IPPP) to treat lumbar foraminal stenosis. Objective: To evaluate the clinical results of lumbar foraminal stenosis treated with IPPP. Summary of Background Data: There is no gold standard for the surgical treatment of foraminal stenosis, which occurs in 8% of surgical cases of lumbar degenerative diseases. Methods: A total of 26 patients who were followed up for a minimum of 2 years after IPPP for foraminal stenosis, were included in this study. The study group consisted of 20 men and 6 women with an average age at surgery of 63.3 years (range: 42 to 83) and a mean follow-up of 5.5 years (range: 2 to 11). The affected levels were L3/4 in I patient, L4/5 in 7, and L5/S1 in 18. Bilateral IPPP at L5/S1 was performed in 2 patients. The clinical results were evaluated according to the Japanese Orthopedic Association (JOA) scoring system. Results: Two patients required revision surgery to correct insufficient decompression. In the remaining 24 patients, the average JOA scores were 6.7 (range: - I to 10) before surgery, 12.4 (range: 9 to 15) 3 months after surgery, 12.3 (range: 9 to 15) 1 year after surgery, and 11.7 (range: 5 to 15) at the final follow-up. The average recovery rate was 62.1% (range: 40.0% to 81.3%). Conclusions: This follow-up study confirms that IPPP affords long-lasting improvements in leg symptoms for patients with lumbar foraminal stenosis.