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General Discussion

Public·38 members

iSERF Media Toolbox Now Available

The iSERF Media Toolbox is now available to help members maintain consistent and professional branding when representing iSERF in presentations, virtual meetings, events, and other communications.


The toolbox includes:

  • iSERF logo files in various formats

  • Zoom background

  • PowerPoint presentation template

  • Flyer template


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Call for Case of the Month Submissions

iSERF is introducing a new Case of the Month feature to highlight meaningful clinical cases, encourage professional discussion, and support knowledge-sharing within the spinal endoscopy community.


We invite iSERF members to submit a case for consideration.


Submissions may include an interesting clinical presentation, diagnostic challenge, surgical approach, technical insight, or key lesson that could benefit fellow members.


Selected cases may be featured in The Column and shared through iSERF’s social media platforms. Please ensure that all patient information is appropriately de-identified and that any required permissions have been obtained before submission.


To submit a case or request additional information, please email membership@iserf.org.


Thank you for helping iSERF create a valuable educational resource for the community.

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Technical discussion: Addressing the foraminal endplate osteophyte

One of the contributors to foraminal stenosis is the osteophyte that arises from the inferior endplate of the cranial vertebrae, extending into the foramen.


Foraminal osteophyte
Foraminal osteophyte

Anecdotally, these seem to be present most often at L5/S1. I'm interested in hearing whether others here have had success addressing these L5/S1 osteophytes endoscopically. I feel like it should be something that can be accessed, but in practice I've had difficulty doing so successfully.


I find that in patients with even a moderately high crest, it is very difficult to reach the medial osteophyte via transforaminal approach due to the caudally-angled trajectory that's required. The more medial you go, the more inferiorly you travel within the foramen. You're also simultaneously trying to protect the exiting L5 root while crossing it dorsally, and I think the risk of DRG irritation is high.


More recently, I've tried taking a contralateral sublaminar approach. I've been doing these biportal,…


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My approach for this pathology is a Uniportal Contralateral foraminotomy. I use a 7mm scope. This technique is effectively the second half of the ULBD approach. It often requires that you undercut the ipsilateral spinous processes and follow the IAP to the foramen.

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