Article
Microsurgical posterior cervical foraminotomy: a study of 181 cases
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Authors
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Ghassan Kerry
- Universitätsklinik für Neurochirurgie, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland
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Alexander Hammer
- Universitätsklinik für Neurochirurgie, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland
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Claus Ruedinger
- Universitätsklinik für Neurochirurgie, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland
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Gholamreza Ranaie
- Universitätsklinik für Neurochirurgie, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland
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Hans-Herbert Steiner
- Universitätsklinik für Neurochirurgie, Paracelsus Medizinische Privatuniversität, Nürnberg, Deutschland
| Published: | June 2, 2015 |
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Outline
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Objective: An unsettled controversy over the appropriate surgical approach in cases of cervical radiculopathy caused by degenerative vertebrae and intervertebral discs is still present. In this retrospective case observational study, we investigate the efficacy of microsurgical posterior cervical foraminotomy in the treatment of cervical radiculopathy examining demographic, clinical, and surgical data.
Method: Patients, who underwent posterior cervical foraminotomy at our department between 2006 and 2013 for unilateral monosegmental soft disc herniation, or spondylosis, or both, were enrolled in this study. Demographic, clinical, and surgical data were retrospectively reviewed. The patients were subsequently interviewed by telephone to identify their long-term outcome. The clinical outcomes were evaluated using Odom's criteria. Descriptive statistics were frequencies and percentage of occurrence for categorical variables and mean and range for continuous variables.
Results: One hundred eighty one patients were included in this study, with a mean follow-up of 43 months (range, 12-96 months). Pure lateral soft disc diseases were encountered in 126 patients (69.6%) while 43 patients (23.8%) were treated due to spondylosis and 12 patients (6.6%) suffered from both pathologies. The overall reoperation rate was 7.2% (13 patients); 11 patients (6%) for recurrent root symptoms due to recurrent disc herniation (6 patients, 3.3%) and restenosis (5 patients 2.8%), one patient (0.55%) for wound infection, and one patient (0.55%) for postoperative hematoma. Among the eleven patients who underwent reoperation for recurrent root symptoms there was one patient who additionally had persistent cerebrospinal fluid leak and superficial posterior wound infection. There was no significant difference between lateral soft disc herniation and spondylosis in term of reoperation rate. At discharge, excellent or good outcome was achieved in 89% of patients; the long-term success rate was 97.2% using Odom's criteria.
Conclusions: Microsurgical posterior cervical foraminotomy is an effective technique for treating lateral spinal root compression. Proper patient selection is obligatory to achieve best results.
