gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

A long-term follow-up of dorsal foraminotomy in cervical disc disease emphasizing neck pain and adjacent level degeneration

Meeting Abstract

  • J. Böttge - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • G. Maier - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • M. Merkle - Neurochirurgie, St. Gertraudenkrankenhaus, Berlin
  • M. Tatagiba - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • F. Roser - Klinik für Neurochirurgie, Universitätsklinikum Tübingen

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocDO.13.08

DOI: 10.3205/12dgnc121, URN: urn:nbn:de:0183-12dgnc1214

Published: June 4, 2012

© 2012 Böttge et al.
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Outline

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Objective: Minimal invasive dorsal foraminotomy for lateral cervical disc disease is an established surgical technique with preservation of the motion segment.

Methods: 71 patients (2006 to 2010) were operated on by a monosegmental minimal invasive dorsal foraminotomy due to lateral or intraforaminal cervical soft disc sequestration. Hard disc disease or median sequestration as also foraminal stenosis were treated via a ventral approach. Surgery was performed in case of neurological deficits or failed conservative treatment. A retrospective analysis was performed with a median follow up period of 31.6 months (range 13–68 months). Patients were evaluated with standard neurological examination, NDI, VAS arm/neck pain and lateral functional x-ray imaging of the cervical spine.

Results: 59% of the patients could be followed up (21/21 male/female patients, mean age 52 y, range 29–78 year). Preoperative motor and sensory dysfunction improved in 80% and remained unchanged in 20%. Preoperative pain (VAS) decreased from 7.6 to 2.2. 60% still complain of neck pain and receive physiotherapy, but only 18% need pain medication. Lateral fexion/extension radiographs showed no adjacent level degeneration or instability of the treated segment however a disc space subsidence (mean 0,3 mm) was noted.

Conclusions: In this series no evidence of adjacent level degeneration or instability due to facet joint violation could be established. However a large number of patients complain of persistent neck pain, which can be attributed to the degree of facet joint opening, but can be well treated by physiotherapy.