gms | German Medical Science

Objective: Anterior cervical uncoforaminotomy (uncoforaminotomy) is an operative method preserving the functional motion segment while removing the underlying pathology in the neuroforamen. Controversy exists concerning the patients best qualifying for this treatment modality. Early postoperative results are reported to be good. However no prospective study evaluating the long-term follow-up has been done. We report about 60 cases out of 195 overall cases of uncoforaminotomy in which follow-up examination was done after 2 years.

Methods: Between November 2002 and November 2006, 195 patients underwent uncoforaminotomy for the treatment of cervical radiculopathy in our neurosurgical department due to soft-disc, hard-disc pathology or a combination of both. Before treatment the patients received preoperative computed tomography (CT) and neurological examination. Surgery was performed according to the method described by Jho. Postoperative examination consisted of a postoperative CT scan before discharge. Additionally follow-up examination was performed 2 years after surgery in 60 patients. All patients were evaluated clinically and CT or MRI images were obtained.

Results: At discharge all patients had excellent or good results. Two years after surgery no patient complained of recurrent radiculopathy. Clinical outcome was evaluated to be excellent in 26 patients, as good in 31 patients and a fair outcome was present in 3 patients. Residual sensory deficits were present in 9 patients. The mean oswestry was 13.5±9. VAS was 3.4±2,8 points for neck pain. CT scans showed progressive segmental degeneration without recurrent foraminal compression. In two patient a anterior cervical discectomy and fusion was performed due to a suspected microinstability.

Conclusions: Uncoforaminotomy especially in patients with soft disc pathologies is a good operative method for the treatment of radicular pain. Patient selection is the important factor. According to the long-term results, anterior uncoforaminotomy is a good alternative treatment for patients with radiculopathy. Preservation of the motion segment makes this method attractive especially in young patients.