2025 Volume 16 Issue 8 Pages 1124-1129
Introduction: In this study, we focus on fatty degeneration of the multifidus muscle after transforaminal full endoscopic spine surgery (TF-FESS) in elderly patients and aim to examine the minimal invasiveness of TF-FESS.
Materials: We conducted 17 patients aged 80 years or older who underwent TF-FESS at our institution. We classified fatty degeneration of the multifidus muscle into five stages using plain MRI and evaluated the progression of degeneration 3 months after surgery. We compared the multifidus muscle on the TF-FESS operated side and the contralateral side in the same patient, and compared it with 20 patients who underwent spinous process splitting laminectomy at one intervertebral level during the same period.
Results: Three months after TF-FESS, there was one case (5.9%) in which fatty degeneration of the multifidus muscle had progressed by one or more stages at the intervertebral level, and one case (9.1%) at the caudal intervertebral level. The results were exactly the same on the contralateral side. In patients after spinous process splitting laminectomy, fatty degeneration progression was significantly more frequent in 8 cases (40.0%) at the operated intervertebral level and in 9 cases (45.0%) at the caudal intervertebral level.
Conclusions: TF-FESS is an effective treatment option that can preserve the multifidus muscle.
