Clinical Evaluation of the Effectiveness of Endoscopic Surgical Treatment in Patients with Lumbar Ligamentous-Foraminal Stenosis

Background: Ligamentous-foraminal stenosis caused by hypertrophy of transforaminal ligaments represents a rare but clinically significant form of spinal nerve root compression. Due to the limited research on this pathology and the lack of a unified surgical approach, minimally invasive techniques aimed at targeted decompression of neural structures are particularly relevant.

Objective: To improve treatment outcomes in patients with ligamentous-foraminal stenosis by refining the technique of endoscopic transforaminal decompression.

Materials and Methods: A retrospective analysis was conducted on the treatment outcomes of 20 patients with confirmed ligamentous-foraminal stenosis who underwent endoscopic transforaminal decompression using an “outside-in” approach. Treatment efficacy was assessed by analyzing pain intensity using the Visual Analog Scale (VAS) and functional limitation using the Oswestry Disability Index (ODI) before and after surgery.

Results: The average preoperative VAS score was 8.1 ± 0.6, and ODI score was 70.4 ± 11.5. Postoperative assessments demonstrated a statistically significant reduction in pain and improvement in functional status. In all patients, hypertrophied transforaminal ligaments were identified; complete decompression of the nerve roots was achieved following resection of these structures. The average hospital stay was one day, and no complications were observed.

Conclusions: Endoscopic transforaminal decompression is a clinically effective and pathogenetically justified method for treating ligamentous foraminal stenosis of the lumbar spine.

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