Abstract

Objectives: Hole approach on the foraminal stenosis and spondylolisthesis has not been described previously. In this study, we aim to give details and results of a new operation technique, used in 136 patients with foraminal stenosis and spondylolisthesis. Patients and Methods: Between March 2001 and 2007, 93 patients with foraminal stenosis and 43 patients with spondylolisthesis, who had conservative treatment before, were operated with hole approach. During operation a hole 0,5-1 cm was opened articular joint edge and conjunction between facet and lamina. At this approach minimally inferomedial edge of the superior facet and superomedial edge of the inferior facet were drilled away by Anspach. Facet capsule leave intact. By guidance of the disc space, the portions and osteofit anteriorly, and medial face of the facet posteriorly were cleaned. Inferior and superior root conjunctions were exposed and interapophyseal space was released. Any instrumentation system and fusion were not used. Patients data included; leg pain, paresthesia, and weakness, return time to daily activity and Oswestry pain score and final outcome. Patients were evaluated with post operative spiral CT and three dimensional reconstruction CT to show the amount of bone removing. Results: All patients were mobilized within 4-6 hr, discharged within 24-48 hr, sat down within 8-12 days, returned to daily activities and works within 15-25 days. Postoperative Oswestry pain score (3,4±1,7) was significantly decreased when compared with the preoperative pain scores (38,8±5,01) in the patients with foraminal stenosis (p<.001). Conclusion: Hole approach may be considered as a safe and effective a new procedure for the patients with foraminal stenosis and spondylolisthesis. This approach will be use multilevel segment and any instrumentation system were not used.