Anterior Cervical Foraminotomy for Unilateral Radicular Disease

Johnson, J. Patrick; Filler, Aaron G.; McBride, Duncan Q.; Batzdorf, Ulrich

doi:10.1097/00007632-200004150-00002

Cited by 100 publications

(52 citation statements)

References 12 publications

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“…AF was developed to avoid the complications associated with immobilization of the spine. Several studies reported that AF provided G/E outcomes in the short- [1][2][3][4] or mid-term [4][5][6], but no long-term studies have been conducted. One of the interesting parts of this study is the inclusion of long-term radiographic outcomes after AF, which has also not been reported previously.…”

Section: Discussionmentioning

confidence: 99%

“…Fusionrelated problems, graft site complications and morbidity of the adjacent segment are supposedly avoided with this method. Since its introduction, it has attracted much attention as the early results were encouraging [1][2][3][4][5][6], but nevertheless this procedure has been accepted by only a few experienced surgeons, mainly because it is a little more technically demanding. Hence, there are very few clinical studies in the literature.…”

Section: Introductionmentioning

confidence: 99%

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Long-term outcomes following anterior foraminotomy for one- or two-level cervical radiculopathy

et al. 2013

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Purpose Anterior foraminotomy (AF) is a surgical treatment for unilateral cervical radiculopathy that avoids fusion-related complications, but its long-term outcome has yet to be investigated. To clarify the efficacy of AF, the author retrospectively collected long-term data regarding the results of this technique. Methods Of 50 patients who underwent AF between November 1999 and June 2005, those who were followed for more than 6 years (n = 44) were enrolled in this study. The parameters studied included the number of revisions, additional surgeries, VAS/NDI, and Odom's criteria. Plain radiographs were also obtained pre-and postoperatively. Results At discharge, 98 % of patients reported improvement, although 20 % temporarily experienced some residual symptoms. There were no other major postoperative complications. At final follow-up (FU, mean of 8.8 years), an excellent or good outcome was achieved in 39 patients (89 %). There was no index level reoperation required, but two additional operations for symptomatic adjacent-segment degeneration were needed (4.5 %). Six patients suffered from shoulder pain on the same side after surgery (mean onset: 3.6 years). At final FU, significant degeneration at the operated level was demonstrated on plain radiographs, resulting in a decreased range of motion. However, loss of lordosis of the segment was minimal. Radiographically, adjacent segment degeneration was noted in only 6 and 11 % at the cranial and caudal segments, respectively.Conclusions In this retrospective study, patients who underwent AF for one-or two-level cervical radiculopathy showed a good long-term outcome with minimal adjacent segment degeneration. However, more data should be collected to clarify possible associations with these findings, such as delayed shoulder problems and aggravation of degeneration at the operated level.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-term outcomes following anterior foraminotomy for one- or two-level cervical radiculopathy

et al. 2013

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“…Anterior decompression and fusion [38] or laminoplasty with or without foraminotomy [30] has been reported. Some authors believe [8,20,21,36] that anterior decompression with or without medial foraminotomy is important for eliminating the anterior and/or anterolateral lesion, whereas some [5,14] advocate posterior laminoplasty with keyhole foraminotomy. In a study of seven patients with distal-type cervical spondylotic amyotrophy treated with central corpectomy, Srinivasa Rao et al [40] reported that six patients had improved by a mean patient-perceived outcome score of 66.7% at a mean follow-up of 46.5 months.…”

Section: Treatmentmentioning

confidence: 99%

Cervical spondylotic amyotrophy

Jiang

Dai

2010

Eur Spine J

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Cervical spondylotic amyotrophy is characterized with weakness and wasting of upper limb muscles without sensory or lower limb involvement. Two different mechanisms have been proposed in the pathophysiology of cervical spondylotic amyotrophy. One is selective damage to the ventral root or the anterior horn, and the other is vascular insufficiency to the anterior horn cell. Cervical spondylotic amyotrophy is classified according to the most predominantly affected muscle groups as either proximaltype (scapular, deltoid, and biceps) or distal-type (triceps, forearm, and hand). Although cervical spondylotic amyotrophy always follows a self-limited course, it remains a great challenge for spine surgeons. Treatment of cervical spondylotic amyotrophy includes conservative and operative management. The methods of operative management for cervical spondylotic amyotrophy are still controversial. Anterior decompression and fusion or laminoplasty with or without foraminotomy is undertaken. Surgical outcomes of distal-type patients are inferior to those of proximal-type patients.

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“…Jho [11,12] also reported microsurgical anterior cervical foraminotomy (ACF) that involved removal of the uncinate process. However, the disadvantages of ACF involve longterm issues related to disc degeneration and unilateral removal of the uncovertebral joint [13,14].…”

Section: Introductionmentioning

confidence: 99%

Transvertebral anterior cervical foraminotomy: midterm outcomes of clinical and radiological assessments including the finite element method

et al. 2013

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Purpose The aim of this study was to compare the clinical features, radiological changes, biomechanical effects, and efficacy in patients treated by transvertebral anterior foraminotomy. Preservation of segmental motion and avoidance of adjacent segment degeneration are theoretical advantages of transvertebral anterior foraminotomy. In practice, this procedure is minimally invasive and has shown good clinical results, especially in patients with unilateral cervical radiculopathy. Method We conducted a retrospective minimum 2-year follow-up study of the cervical spine of patients treated by transvertebral anterior foraminotomy at our institution. Radiological outcomes, which were estimated by measuring disc and functional spinal unit heights, and the angle and range of motion (ROM) from C2 to C7 of the functional spinal unit and adjacent segments were evaluated. Furthermore, a three-dimensional finite element method was used to biomechanically analyze the strength of the postoperative vertebral body. Results Between 2004 and 2009, 34 patients underwent surgery. The improvement rate was 94.2 %. The average flexion-extension ROM from C2 to C7 was 36.6 ± 16.6°. On plain radiographs, the disc height and ROM and height of the functional spinal unit in the operated segment were not significantly decreased relative to the preoperative levels. The finite element method also revealed that there was no difference in strength between the pre-and postvertebral bodies.Conclusions These results demonstrate that biomechanical stability was achieved. Transvertebral anterior cervical foraminotomy did not limit motion in the operated and adjacent segments and did not cause a significant decrease in disc and vertebral heights after surgery.

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Anterior Cervical Foraminotomy for Unilateral Radicular Disease

Cited by 100 publications

References 12 publications

Long-term outcomes following anterior foraminotomy for one- or two-level cervical radiculopathy

Long-term outcomes following anterior foraminotomy for one- or two-level cervical radiculopathy

Cervical spondylotic amyotrophy

Transvertebral anterior cervical foraminotomy: midterm outcomes of clinical and radiological assessments including the finite element method

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