{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:07:59Z","timestamp":1790892479901,"version":"4.1.0"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:p>Approximately half a million spinal fusion procedures are performed annually in the US. It is estimated that up to one-third of arthrodesis constructs require revision surgeries. In this study the authors present endoscopic treatment strategies targeting 3 types of complications following arthrodesis surgery: 1) adjacent-level foraminal stenosis; 2) foraminal stenosis at an arthrodesis segment; and 3) stenosis caused by a displaced interbody cage.<\/jats:p>\n                  <jats:p>A retrospective chart review of 11 patients with a mean age of 68 \u00b1 15 years was performed (continuous variables are shown as the mean \u00b1 SEM). All patients had a history of lumbar arthrodesis surgery and suffered from unilateral radiculopathy. Endoscopic revision surgeries were done as outpatient procedures, and there were no intraoperative or perioperative complications. The cohort included 3 patients with foraminal stenosis at the level of previous arthrodesis. They presented with unilateral radicular leg pain (visual analog scale [VAS] score: 7.3 \u00b1 2.1) and were severely disabled, as evidenced by an Oswestry Disability Index (ODI) of 46 \u00b1 4.9. Transforaminal endoscopic foraminotomies were performed, and at a mean follow-up time of 9.0 \u00b1 2.5 months VAS was reduced by an average of 6.3. The cohort also includes 7 patients suffering unilateral radiculopathy due to adjacent-level foraminal stenosis. Preoperative VAS for leg pain of the symptomatic side was 6.0 \u00b1 1.6, VAS for back pain was 5.2 \u00b1 1.7, and ODI was 40 \u00b1 6.33. Endoscopic decompression led to reduction of the ipsilateral leg VAS score by an average of 5, resulting in leg pain of 1 \u00b1 0.5 at an average of 8 months of follow-up. The severity of back pain remained stable (VAS 4.2 \u00b1 1.4). Two of these patients required revision surgery for recurrent symptoms. Finally, this study includes 1 patient who presented with weakness and pain due to retropulsion of an L5\/S1 interbody spacer. The patient underwent an endoscopic interlaminar approach with partial resection of the interbody cage, which resulted in complete resolution of her radicular symptoms.<\/jats:p>\n                  <jats:p>Endoscopic surgery may be a useful adjunct for management of certain arthrodesis-related complications. Endoscopic foraminal decompression of previously fused segments and resection of displaced interbody cages appears to have excellent outcomes, whereas decompression of adjacent segments remains challenging and requires further investigation.<\/jats:p>","DOI":"10.3171\/2015.10.focus15503","type":"journal-article","created":{"date-parts":[[2016,2,1]],"date-time":"2016-02-01T03:36:55Z","timestamp":1454297815000},"page":"E10","source":"Crossref","is-referenced-by-count":22,"title":["Early experience with endoscopic revision of lumbar spinal fusions"],"prefix":"10.3171","volume":"40","author":[{"given":"Lynn B.","family":"McGrath","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Washington, Seattle, Washington; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthik","family":"Madhavan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, and The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee Onn","family":"Chieng","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, and The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Y.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, and The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph P.","family":"Hofstetter","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Washington, Seattle, Washington; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus15503","series-title":"Spine (Phila Pa 1976)","first-page":"2351","article-title":"Degenerative spondylolisthesis: does fusion method influence outcome? Four-year results of the spine patient outcomes research trial","volume":"34","author":"Abdu","year":"2009"},{"issue":"3 Suppl","key":"b2-focus15503","series-title":"J Neurosurg","first-page":"320","article-title":"Posterolateral percutaneous endoscopic lumbar foraminotomy for L5-S1 foraminal or lateral exit zone stenosis. Technical note","volume":"99","author":"Ahn","year":"2003"},{"issue":"Suppl 1","key":"b3-focus15503","series-title":"Neurosurgery","first-page":"34","article-title":"The future of the use of spine surgery","volume":"60","author":"Cheng","year":"2013"},{"key":"b4-focus15503","series-title":"Spine (Phila Pa 1976)","first-page":"2238","article-title":"Adult spinal deformity surgery: complications and outcomes in patients over age 60","volume":"32","author":"Daubs","year":"2007"},{"key":"b5-focus15503","series-title":"JAMA","first-page":"1259","article-title":"Trends, major medical complications, and charges associated with surgery for lumbar spinal stenosis in older adults","volume":"303","author":"Deyo","year":"2010"},{"key":"b6-focus15503","series-title":"J Clin Neurosci","first-page":"730","article-title":"Endoscopic lumbar foraminotomy","volume":"22","author":"Evins","year":"2015"},{"issue":"5","key":"b7-focus15503","series-title":"Neurosurg Focus","first-page":"e5","article-title":"Microendoscopic approach to far-lateral lumbar disc herniation","volume":"7","author":"Foley","year":"1999"},{"key":"b8-focus15503","series-title":"Clin Neurol Neurosurg","first-page":"1961","article-title":"Clinical success of transforaminal endoscopic discectomy with foraminotomy: a retrospective evaluation","volume":"115","author":"Jasper","year":"2013"},{"key":"b9-focus15503","series-title":"Clin Neurol Neurosurg","first-page":"117","article-title":"Posterolateral fusion with interbody for lumbar spondylolisthesis is associated with less repeat surgery than posterolateral fusion alone","volume":"138","author":"Macki","year":"2015"},{"key":"b10-focus15503","series-title":"Spine (Phila Pa 1976)","first-page":"67","article-title":"Spinal fusion in the United States: analysis of trends from 1998 to 2008","volume":"37","author":"Rajaee","year":"2012"},{"key":"b11-focus15503","series-title":"Spine (Phila Pa 1976)","first-page":"817","article-title":"Risk-benefit assessment of surgery for adult scoliosis: an analysis based on patient age","volume":"36","author":"Smith","year":"2011"},{"key":"b12-focus15503","series-title":"Surg Neurol Int","first-page":"62","article-title":"Endoscopic foraminotomy for recurrent lumbar radiculopathy after TLIF: technical report","volume":"6","author":"Telfeian","year":"2015"},{"key":"b13-focus15503","series-title":"Spine (Phila Pa 1976)","first-page":"1872","article-title":"Surgical outcomes of decompression, decompression with limited fusion, and decompression with full curve fusion for degenerative scoliosis with radiculopathy","volume":"35","author":"Transfeldt","year":"2010"},{"key":"b1-focus15503","series-title":"Spine (Phila Pa 1976)","first-page":"2351","article-title":"Degenerative spondylolisthesis: does fusion method influence outcome? 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