Artikel
Results of posterior foraminotomy and anterior discectomy with PMMA fusion for 361 patients with cervical radiculopathy
Ergebnisse nach posteriorer Foraminotomie und anteriorer Diskektomie mit PMMA-Fusion bei 361 Patienten mit zervikaler Radikulopathie
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Autoren
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Marcus Christopher Korinth
- Neurochirurgische Klinik, Universitätsklinikum Aachen, Aachen
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A. Krüger
- Neurochirurgische Klinik, Universitätsklinikum Aachen, Aachen
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M. F. Oertel
- Neurochirurgische Klinik, Universitätsklinikum Aachen, Aachen
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J. M. Gilsbach
- Neurochirurgische Klinik, Universitätsklinikum Aachen, Aachen
| Veröffentlicht: | 23. April 2004 |
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Gliederung
Text
Objective
Cervical disc disease can lead to morphologic different disc lesions, which again may differ in clinical presentation, operative treatment and outcome. Considering the current literature engaged with this topic, there is still no consensus as to which is the ideal approach, and best operative management in each constellation.
Methods
We retrospectively analysed all patients which were treated operatively for single-level cervical disc disease in our institution between 1993 and 2000 and excluded those patients with myelopathy, traumatic or recurrent discopathy. Of the remaining patients with pure radiculopathy, which were either treated with anterior microdiscectomy and PMMA fusion (Group A/ 182 patients) or foraminotomy (Group B/ 179 patients), the charts and neuroradiological findings were analysed and the outcome was evaluated via questionnaire.
Results
Follow-up was possible in 361 patients (80.4%), the observation time ranged from 3-10 years (mean, 4.6 years). The mean age of the 212 male and 149 female patients was 47.5 years (range, 26-78 years). Mean preoperative duration of symptoms was 7.8 months (A) and 3.6 months (B), with existence of motor deficits in 58.2% (A) and 68.7% (B). Pure soft discs were found in 33% (A) and 82.7% (B), pure hard discs in 31.9% (A) and 6.1% (B), whereas a combination of hard and soft disc was found in 35.1% (A) and 11.2% (B). Of all 361 patients, 50.6% of group A and 59.1% of group B were without any symptoms with excellent outcome, 37.4% of group A and 26.3% of group B had good outcome, and 9.3% in group A as well as 7.3% in group B had fair outcome. Poor outcome, making reoperation necessary, was seen in 2.7% (A) and 7.3% (B).
Conclusions
Although different in various basic properties, both procedures were successful for treatment of cervical radiculopathy caused by monosegmental cervical disc disease. Both methods are safe and reliable, with few complications and comparable outcome, but each indication has still to be done individually under consideration of symptoms, radiological findings and the patients' needs.
