Facetectomy for the relief of intraforaminal compression of the fifth lumbar root at the collapsed lumbosacral disk.

This paper presents a long-term follow-up of 23 patients with collapsed lumbosacral disks showing evidence of fifth lumbar root compression treated by facetectomy without fusion. Fifth lumbar root compression is usually caused by protrusion of the fourth lumbar disk. If this is not present the fifth lumbar root will almost invariably be found to be impinged upon laterally in the foramen by one of several mechanisms, which are detailed in this paper. Decompression of the roots at the fifth lumbar foramen may be done by either unilateral or bilateral facetectomy depending upon whether the symptoms are unilateral or bilateral. There has been no forward displacement with unilateral facetectomy and only slight forward movement of the fifth lumbar vertebrae on the sacrum with bilateral facetectomy. There has been good relief of symptoms in most patients. Arthrodesis, as a rule, is not necessary.