Transforaminal Endoscopic Decompression of the Lumbar Spine for Stable Isthmic Spondylolisthesis as the Least Invasive Surgical Treatment Using the YESS Surgery Technique

ABSTRACT

The first author's series has reported and published his 5- to 10-year results in a preliminary review of endoscopic transforaminal decompression for degenerative and isthmic spondylolisthesis causing sciatica and back pain. This study was initiated due to favorable results in relieving both back and leg pain after a spine surgeon with isthmic spondylolisthesis who wanted to avoid fusion requested consideration for an endoscopic procedure for his own isthmic spondylolisthesis condition. After listening to the first author's podium presentation on selective endoscopic discectomy and foraminal decompression under local anesthesia in 1995, he requested consideration for transforaminal endoscopic decompression for recent onset of progressive sciatica from his isthmic spondylolisthesis. He was the first patient to undergo endoscopic decompression in our series of 55 patients from January 2002 to December 2012 that served as the database for a clinical case series review of selective endoscopic discectomy and foraminoplasty in patients with degenerative spondylolisthesis who specifically chose to stage the author's endoscopic transforaminal decompressive trademarked procedure over fusion.

The patients were evaluated and considered for the endoscopic procedure specifically at their request, even though they were informed about the traditional “gold standard” fusion for surgical intervention. At that time the medical field did not have the database to study outcomes other than the favorable clinical results found in patients who underwent selective endoscopic discectomy and foraminoplasty for degenerative spondylolisthesis. These patients were accepted for endoscopic spine surgery in a shared clinical decision after full disclosure. The patients opted specifically for the Yeung Endoscopic Spine Surgery (YESS) technique that included foraminoplasty and dorsal endoscopic rhizotomy from the author's evolving clinical experience of 10,000 cases over 27 years.