Endoscopic Lumbar Foraminotomy (ELF)

What Is Endoscopic Lumbar Foraminotomy?

Endoscopic lumbar foraminotomy is a minimally invasive surgery used to relieve pressure caused by compression from bone spurs, disc herniations, scar tissue, or excessive ligament development. With a quick recovery time, foraminotomy surgery patients are often up and back to normal activities in no time.

Advantages of endoscopic lumbar foraminotomy surgery include the following:

Minimally invasive

Small incision

Short recovery

Same day surgery with no hospitalization (outpatient procedure)

High success rates

Local anesthesia

Preservation of spinal mobility

Minimal or no blood loss

Minimal scar tissue formation

What Conditions Can Endoscopic Lumbar Foraminotomy Surgery Treat?

Endoscopic lumbar foraminotomy can be used to treat a number of conditions in the lumbar region of the spine (lower back). The following are some of the spinal conditions that can be effectively treated with this procedure.

Arthritis of the spine

Bulging disc

Bone spurs

Failed back surgery syndrome

Foraminal narrowing (foraminal stenosis)

Spine degeneration



Disc herniation


Spinal slippage (spondylolisthesis)

Spinal instability

Spinal stenosis

When Is Endoscopic Lumbar Foraminotomy Recommended?

Endoscopic lumbar foraminotomy is generally recommended in the following situations:

Severe back pain radiating down to the lower extremities.

Conventional treatments fail to work after three months, such as pain medications, rest, physical therapy, and/or chiropractic adjustment

CT scans and MRI showing nerve compression in the lumbar region of the spine

How Is Endoscopic Lumbar Foraminotomy Surgery Done?

During endoscopic foraminotomy surgery, the patient is brought to the operative room, and intravenous sedation is administered. Under local anesthesia, a small metal tube, the size of a pencil, is inserted into the lumbar spinal nerve hole (neuroforamen). The surgical tools are inserted through this tube so that your muscles do not need to be torn or cut open. The spinal nerve is found with a camera looking through the tube, and protected. Under direct vision, bone spurs, scars, ligament overgrowth, protruded discs, and part of the troubled lumbar facet are removed with appropriate tools (eg, a laser, radiofrequency or mechanical tools) to enlarge the nerve hole and to release the compressed nerve(s). Finally, the tube is removed and the incision is closed with a stitch or two.

Upon completion, the patient is encouraged to walk around and is free to leave the surgical center, with a companion, the same day. After a follow-up visit with the surgeon the next day, the patient can go home for a quick recovery.

Bone cleared  Nerve examined  Herniated portion of disc removed.

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