Guidance
2 The procedure
2.1 Indications
2.1.1 Endoscopic laser foraminoplasty is used mainly to treat chronic back and leg pain from a variety of causes. Annually, 2–5% of people suffer acute back pain, and 0.5% of these have pain and neurological conditions requiring surgery.
2.2 Outline of the procedure
2.2.1 This endoscope-assisted laser technique is used to widen the lumbar exit foramina for nerves from the lumbar spine. A laser is inserted to ablate portions of the intervertebral disc that have protruded and caused narrowing of the foramina.
2.3 Efficacy
2.3.1 The research on efficacy undertaken to date is based on case series only and has all been led by a single clinician. In general, pain was decreased after the procedure. For more details, refer to the sources of evidence section.
2.3.2 The Specialist Advisors believed the efficacy of this procedure to be unproven.
2.4 Safety
2.4.1 The research on safety undertaken to date has all been led by a single clinician. The rates of reported complications were low, with discitis and neurological deficit being the most common (both with incidence lower than 1%). For more details, refer to the sources of evidence section.
2.4.2 The Specialist Advisors noted a number of potential complications including nerve injury and infection.