gms | German Medical Science

Objective: To evaluate in a retrospective study the effectiveness of posterior foraminotomy in means of long-term outcome in patients with single and double level cervical radiculopathy over a period of 7 years in a neurosurgical practice.

Method: Over a period of seven years 147 patients (75 m/72 f) underwent single (n=112) or double (n=35) level one-sided posterior foraminotomy for radiculopathy due to disc herniation. All procedures were done by the senior author. Follow-ups were performed after 6 weeks and 3 months postoperatively including pain assessment by the visual analogue scale, assessment of quality of life with a basic tool and neurological examination.

Results: 121 patients were available for follow-up at six weeks and three months postoperatively. Of these patients 14 underwent double level posterior foraminotomy. 13 patients underwent posterior foraminotomy due to persistent foraminal stenosis after ventral discectomy. Complications included wound seroma or infection in 5 patients but without the need of surgical revision. There was no neurological deterioration postoperatively or after three months of follow-up. Most of the patients (n=109) received good to very good improvement according to the visual analogue scale (VAS). Overall, the mean VAS score was at 7 preoperatively and changed to 2 at six weeks and to a mean score of 3 at three months follow-up. The mean duration of the procedure was approximately 65 minutes.

Conclusions: Posterior foraminotomy is a reasonable procedure for cervical disc herniation or isolated foraminal stenosis with radiculopathy in terms of outcome, patients' satisfactory, complications and time effort. It should be kept in the portfolio of neurosurgical procedures.