Full-Endoscopic Foraminal Decompression for Foraminal Stenosis Following Osteoporotic Vertebral Fracture in an Elderly Woman Under Local Anesthesia:A Case Report

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  • Otake Yu
    Department of Orthopedics, Tokushima University, Tokushima, Japan Department of Orthopedic Surgery, St. Lukas Hospital, Tokyo, Japan
  • Tezuka Fumitake
    Department of Orthopedics, Tokushima University, Tokushima, Japan
  • Yamashita Kazuta
    Department of Orthopedics, Tokushima University, Tokushima, Japan
  • Morimoto Masatoshi
    Department of Orthopedics, Tokushima University, Tokushima, Japan
  • Sugiura Kosuke
    Department of Orthopedics, Tokushima University, Tokushima, Japan
  • Takeuchi Makoto
    Department of Orthopedics, Tokushima University, Tokushima, Japan
  • Tamaki Shunsuke
    Department of Orthopedics, Tokushima University, Tokushima, Japan
  • Fujitani Junzo
    Department of Orthopedics, Tokushima University, Tokushima, Japan
  • Kageyama Hiroshi
    Department of Orthopedics, Tokushima University, Tokushima, Japan
  • Sairyo Koichi
    Department of Orthopedics, Tokushima University, Tokushima, Japan

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<p>Osteoporotic vertebral fracture (OVF) is common in the elderly population. In this report, we describe a case with radiculopathy due to foraminal stenosis caused by OVF in a very elderly patient that was treated successfully by full-endoscopic foraminotomy under local anesthesia. The patient was an 89-year-old woman who presented with a chief complaint of left leg pain for 5 years. She visited a couple of hospitals and finally consulted us to determine the exact cause of the pain. Computed tomography scans were obtained and selective nerve root block at L3 was performed. The diagnosis was radiculopathy at L3 due to foraminal stenosis following OVF. The patient had severe heart disease, so we decided to avoid surgery under general anesthesia and planned full-endoscopic spine surgery under local anesthesia. We performed transforaminal full-endoscopic lumbar foraminotomy at L3-L4 to decompress the L3 nerve root. The leg pain disappeared completely immediately after surgery. Postoperative computed tomography confirmed appropriate bone resection. The leg pain did not recur during a year of postoperative follow-up. OVF may cause lumbar radiculopathy as a result of foraminal stenosis, and transforaminal full-endoscopic lumbar foraminotomy under local anesthesia would be the best option in an elderly patient with poor general condition. J. Med. Invest. 71 : 179-183, February, 2024</p>

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