Introduction: A significant percentage of patients demonstrate symptomatic lumbar radiculopathy following trauma. Here we evaluate the outcomes of patients who developed persistent radiculopathy following trauma and were treated with this microblade shaver.

Methods: A total of 133 foramina in 58 patients were reviewed prospectively. We performed neuroforaminal decompression using the IoFlex shaver. Outcome variables included intraoperative radiographic decompression based on preoperative, intraoperative, and postoperative films and clinical assessment using visual analog scale for back pain, visual analog scale for leg pain, and the Oswestry disability instruments. Furthermore, patients completed outcome measures and were interviewed on follow up to assess return to, type, and frequency of sport, return to and type of work, along with return to sexual activity.

Results: 58 patients, 38 males and 20 females were treated with the Baxano IoFlex shaver. Mean patient age was 53.24 years, mean duration of pain before surgery was 8.74 months, and mean follow up was 22.3 months. All patients were available at each follow-up interval. Clinical results were evaluated by assessing preoperative and postoperative axial back pain, radiculopathy, disability, and modified Stauffer-Coventry scores. Patients showed statistically significant improvement in ODI and VAS scores at all follow-up periods compared to baseline (P < 0.0001). The mean ODI score at baseline was 64.2,which improved to a mean of 34.6.The mean VAS back score at baseline was 6.83,which improved to a mean of 2.36. The mean VAS leg score at baseline was 7.82, which improved to a mean of 1.8. Using the modified Stauffer-Coventry classification the 93.9% of patients reported good to excellent results. The mean interval from surgery to return to sports was 53 days. The mean interval from surgery to return to work for the 41 patients in employment was 33 days (range 19-52). The mean interval to return to sexual activity for the 38 patients in relationships was 28 days (range 21-48).

Conclusions: Using the Baxano IoFlex as a means of intraforaminal decompression appears to be a safe and effective treatment for persistent and painful lumbar radiculopathy following trauma.

Patient Care: Current decompression techniques may result in inadequate decompression of the neural foramen or excessive resection of the facet joint. This flexible microblade shaver represents a direct method of performing a foraminioplasty while preserving the facet joints.

Learning Objectives: The present study evaluates our subset of patients through their patient perceived outcomes, return to sport, return to sexual activity, and their return to work.

References: Spine (Phila Pa 1976). 2010 Dec 15;35(26 Suppl):S287-93. doi: 10.1097/BRS.0b013e3182023268. Technical advances in minimally invasive surgery: direct decompression for lumbar spinal stenosis. Lauryssen C.