Cervical disc foraminal surgery' by Dr. Moon Dong-eon, an anesthesiologist who is receiving attention overseas
Reporter's nameLee Byeong-moon, medical expert reporter Posted 2025.03.20 11:33 Comments 0
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Seven medical staff from Singapore, Indonesia, etc. visited Korea to observe the procedure.
After local anesthesia, a 2.6mm special kit was inserted into the intervertebral space on the side.
Overseas doctors were amazed at the relief of stenosis pain in just 20 minutes.
A scene of a procedure in which the yellow ligament and intervertebral ligament are scraped off using a 'foraminoplasty' kit to secure a nerve passage in the intervertebral foramen for a patient with spinal stenosis (55, male). Doctors from Singapore and Indonesia are observing the procedure. Provided by Moon Dong-eon Anesthesiology and Pain Medicine Department
A scene of a procedure in which the yellow ligament and intervertebral ligament are scraped off using a 'foraminoplasty' kit to secure a nerve passage in the intervertebral foramen for a patient with spinal stenosis (55, male). Doctors from Singapore and Indonesia are observing the procedure. Provided by Moon Dong-eon Anesthesiology and Pain Medicine Department
Patients with spinal stenosis who are not treated with medication and physical therapy require 'neuroplasty (nerve blocking)'. When the nerve roots are entangled and there is adhesion around the nerves, 'neuroplasty' or 'balloon neuroplasty' is performed by inserting a plastic catheter into the tailbone to tear off the adhesion. Unlike nerve injection treatment that only treats nerve root inflammation, it is effective because it directly separates the adhesion using the elasticity of the catheter and the balloon and then treats the inflammation of the nerve root.
However, when the nerve adhesion is very severe and the flavus ligament is thickened to narrow the spinal canal or intervertebral foramen, it is difficult to expect a therapeutic effect. This is because, unlike foraminoplasty, neuroplasty or balloon neuroplasty cannot scrape out the abnormally thickened flavus ligament and intervertebral foramen.
In such cases, surgery is usually performed to widen the spinal canal by cutting the bone and inserting screws. However, most elderly patients with diabetes, heart disease, and other diseases often give up treatment because it is dangerous to undergo a major surgery under general anesthesia. In this regard, the 'intervertebral foraminal ...
◇Fundamental treatment for stenosis with less pain and higher treatment success rate= The specially developed intervertebral foraminal plasty to remove the thickened yellow ligament in patients with spinal stenosis without surgery is known overseas and is receiving attention. Recently, seven specialists, including neurosurgeon Rajendra T from the Spine Center of the National Neuroscience Institute at Gleneagles Hospital in Singapore, anesthesiologist Mirza K from the Pain Center at Soedono Hospital in Indonesia, and neurologists from various regions including Jakarta, Indonesia, visited the Department of Anesthesiology and Pain Medicine at Moon Dong-eon to observe the intervertebral foraminal plasty.
The foreign doctors’ observation took place over two days. They watched the process of Director Moon Dong-eon performing intervertebral disc foraminal surgery on patients with spinal stenosis and patients with post-surgery pain using a specially-made kit, and also shared video data and surgical techniques. The foreign doctors who attended expressed surprise and admiration at the development of the ‘Foramoon’ kit, which was specially made to treat stenosis without surgery. There were lively questions during the discussion. The foreign doctors said, “We will return to our home countries and apply it to actual patients right away,” showing the changed status of Korean medicine.
Director Moon Dong-eon of the Department of Anesthesiology and Pain Medicine and foreign doctors are taking a commemorative photo after observing and discussing a lumbar discectomy procedure.
Director Moon Dong-eon of the Department of Anesthesiology and Pain Medicine and foreign doctors are taking a commemorative photo after observing and discussing a lumbar discectomy procedure.
◇Foraminoplasty is a procedure performed under local anesthesia without skin incision = Foraminoplasty is a treatment method that scrapes away abnormally thickened ligaments of the flavus and intervertebral foraminal ligaments to secure space for the nerves to pass through, removes nerve adhesions, and at the same time, removes scars attached to the bones around the joints to expand the intervertebral foramina and spinal canal.
As the passage through which the spinal nerves pass widens, the pressure on the nerve roots decreases, and the pressure on the arteries and veins also decreases, which improves circulation, increases blood supply to the nerve roots, and facilitates the supply of oxygen and nutrients. Eventually, inflammation in the nerve roots is treated, leg pain is reduced, and numbness and tingling are improved, allowing you to walk with your back straight.
Existing nonsurgical treatments can only treat lateral stenosis, which is a narrowing of the intervertebral foramen, but this treatment can treat central stenosis, which is a narrowing of the spinal canal, in addition to lateral stenosis. The diameter of the instrument is very thin at 2.6mm, so the procedure can be performed with only local anesthesia without skin incision. There is almost no bleeding or pain during the procedure, and the procedure time is very short, about 20 minutes.
Director Moon Dong-eon explained, "Most patients with spinal stenosis have multiple spinal canals or intervertebral foramina narrowed at the same time. Unlike other devices, this device can treat multiple intervertebral foramina on both sides with a single procedure." He continued, "The balloon catheter included in this kit removes neural adhesions and treats neuroinflammation, restoring normal spinal nerve mobility. For this reason, it is a very effective treatment method, unlike intervertebral foramina expansion surgery that simply increases the size of the intervertebral foramina."
◇ Very high treatment success rate of 74.5%… Also effective for patients with relapse = Patients for whom it is difficult to expect results from neurolysis or balloon neurolysis due to severe blockage of the spinal canal or intervertebral foramina, or for whom the procedure did not work, patients with a thickened ligamentum flavum that has narrowed the neural passage, patients with persistent or recurrent pain after spinal surgery, patients with a posterior joint cyst that compresses the nerve root, patients with a ruptured and prolapsed disc that causes severe nerve compression, elderly patients who are reluctant to undergo surgery, or patients for whom surgery is not possible due to underlying diseases can also undergo this procedure. However, surgery should be considered in cases where anterior displacement and spinal instability are severe or where stenosis has worsened due to the growth of a bone spur.
Director Moon Dong-eon announced the treatment results using a lumbar foraminoplasty kit for 110 patients with spinal stenosis (central and lateral stenosis) from December 2018 to January 2020. As a result of a follow-up survey for 6 months after treatment, 74.5% (82 out of 110) showed a decrease in pain of more than 50% or an improvement in walking distance and disability index, and 78.2% of patients said they were very satisfied or satisfied with the treatment effect. There were no serious side effects other than temporary pain and numbness. Since this study was the result of a study using the newly developed 'lumbar foraminoplasty kit', it attracted much attention not only from members of the domestic pain society but also from foreign doctors. It was published in the prestigious international pain-related academic journal (Pain Physcian) in 2021.
Medical Specialist Reporter Lee Byeong-moon
