Conventional surgical approaches for lumbar foraminal stenosis or far lateral stenosis can be categorized as total facetectomy with/ without fusion and facet-preserving microforaminotomy. Total facetectomy offers sufficient decompression through the nerve root course. However, this often leads to segmental lumbar instability and back pain 1) 2) 3) 4).
see Medial facetectomy.
see Complete facetectomy.
Findings demonstrate that bilateral facetectomy (BF) during single-level TLIF improves clinical outcomes to a greater degree than unilateral facetectomy (UF) without any notable differences in perioperative complications or radiographic measurements 7).
Seventy-eight patients who had been operated on for bony entrapment of lumbar nerve roots were studied in an attempt to define the clinical syndrome, and to assess the results of a new technique of decompression which preserves spinal stability. The mean age of the patients was 45 years and 28 of them had previously undergone spinal operations. Pain in the leg was the predominant symptom, with evidence of motor involvement in half of the patients. Signs of nerve root tension were found in only one-third of the patients. The principal factor in the aetiology was degenerative change in the posterior facet joints. Decompression was achieved by a partial undercutting facetectomy. Fifty-nine per cent of the patients obtained a “good” result and 85 per cent were satisfied with the result of their operation. Successful partial facetectomy for bony entrapment of lumbar nerve roots produced rapid and lasting relief of pain 8).