Risk factors for outcome and complications of dorsal foraminotomy in cervical disc herniation

Jödicke, Andreas; Daentzer, Dorothea; Kästner, Stefanie; Asamoto, Shunji; Böker, D.-K.

doi:10.1016/s0090-3019(03)00267-2

Cited by 44 publications

(22 citation statements)

References 17 publications

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“…The immediate success rates for symptom resolution vary from 82% to 100%, 19,25,26 but long-term outcomes are even more variable, with success rates ranging from 75% to 97%. 2,3,9,10,13,14,16,18,23,24,26 In this study, we correlated the preoperative symptoms of patients who underwent PCF with postoperative outcomes and documented the rate of and time to reoperation.…”

Section: Discussionmentioning

confidence: 99%

Long-term patient outcomes after posterior cervical foraminotomy: an analysis of 151 cases

Bydon

Mathios

Macki

et al. 2014

SPI

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Object The authors conducted a study to investigate the rate and timing of reoperation due to symptom recurrence after unilateral posterior cervical foraminotomy (PCF). Methods The authors retrospectively reviewed demographic, surgical, and clinical data from 151 patients who underwent unilateral PCF at their institution with an average follow-up of 4.15 years. The main outcome variables were reoperation rate, time to reoperation, and short- and long-term radiculopathy improvement rates. Kaplan-Meier analyses were conducted to assess risk of reoperation and recurrence of radiculopathy over time. Results After index PCF in 151 patients, the overall reoperation rate was 9.9% (15 patients). The average time until reoperation was 2.4 years, and the average last follow-up examination was 4.15 years after the first surgery. Patients who presented with preoperative neck pain in addition to radiculopathy had a higher risk for reoperation and a shorter time to reoperation. The majority of patients who underwent a reoperation had an anterior cervical discectomy and fusion (80%). A smaller number of patients had reoperation that included a repeat PCF (6.7%) or laminectomy with posterior cervical fusion (13.3%). The rate of same-level reoperation (6.6%, 10 patients) was significantly higher (p = 0.05) when compared with adjacent-segment (1.3%, 2 patients) or distant-segment (1.9%, 3 patients) reoperation. At last follow-up, the overall rate of improvement in radiculopathy was 85%, with the majority of patients (91.4%) experiencing resolution as early as 1 month after index surgery. Following the subgroup that experienced initial symptom improvement, 16.1% of these patients experienced radiculopathy recurrence an average of 7.3 years after the initial operation. While the reoperation rate for the overall cohort in this series was 9.9%, patients with follow-up periods longer than 2 years had a reoperation rate of 18.3%. Moreover, patients with more than 10 years of follow-up had a reoperation rate of 24.3%. Conclusions PCF is a procedure performed to address nerve root compression in the cervical spine. The authors evaluated 151 patients who underwent unilateral PCF and found a reoperation rate of 9.9% at an average of 2.4 years after the initial surgery (6.6% at same level, 3.3% elsewhere). The reoperation rates reached 18.3% and 24.3% in patients with follow-up periods longer than 2 and 10 years, respectively. The authors' analysis revealed that patients with no preoperative neck pain had the lowest rates of revision surgery after PCF.

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Section: Discussionmentioning

confidence: 99%

Long-term patient outcomes after posterior cervical foraminotomy: an analysis of 151 cases

Bydon

Mathios

Macki

et al. 2014

SPI

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“…The effectiveness of posterior foraminotomy for cervical radiculopathy is reported to be 82.1%-86.4%. 10,13,14 The advantages of posterior foraminotomy include the avoidance of complications associated with anterior approaches to the cervical spine and the lack of need for cervical fusion. In the current case, posterior fo- Here, we reported a case of C-4 radiculopathy lacking myelopathic symptoms and caused by C3-4 foraminal stenosis with a beak-type OPLL.…”

Section: Discussionmentioning

confidence: 99%

The characteristic clinical symptoms of C-4 radiculopathy caused by ossification of the posterior longitudinal ligament

Katsumi

Yamazaki

Watanabe

et al. 2014

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Cervical radiculopathy of the C2–4 spinal nerves is a rare condition and is poorly documented in terms of clinical symptoms, hindering its detection during initial patient screening based on imaging diagnostics. The authors describe in detail the clinical symptoms and successful surgical treatment of a patient diagnosed with isolated C-4 radiculopathy. This 41-year-old man suffered from sleep disturbance because of pain behind the right ear, along the right clavicle, and at the back of his neck on the right side. The Jackson and Spurling tests were positive, with pain radiating to the area behind the patient's ear. Unlike in cases of radiculopathy involving the C5–8 spinal nerves, no loss of upper-extremity motor function was seen. Magnetic resonance imaging showed foraminal stenosis at the C3–4 level on the right side, and multiplanar reconstruction CT revealed a beak-type ossification of the posterior longitudinal ligament in the foraminal region at the same level. In the absence of intracranial lesions or spinal cord compressive lesions, the positive Jackson and Spurling tests and the C3–4 foraminal stenosis were indicative of isolated C-4 radiculopathy. Microscopic foraminotomy was performed at the C3–4 vertebral level and the ossified lesion was resected. The patient's symptoms completely resolved immediately after surgery. To the authors' knowledge, this report is the first to describe the symptomatic features of isolated C-4 radiculopathy, in a case in which the diagnosis has been confirmed by both radiological findings and surgical outcome. Based on this case study, the authors conclude that the characteristic symptoms of C-4 radiculopathy are the presence of pain behind the ear and in the clavicular region in the absence of upper-limb involvement.

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“…Posterior laminoforaminotomy/foraminotomy and/or discectomy The effectiveness of posterior foraminotomy/discectomy for treating foraminal stenosis and disc herniation is well established 11,24,29,30,32,48) . The advantages of posterior foraminotomy/discectomy include the avoidance of complications associated with anterior approaches to the cervical spine and no need for cervical fusion and instrumentation.…”

Section: Posterior Approachesmentioning

confidence: 99%

Cervical Radiculopathy due to Cervical Degenerative Diseases : Anatomy, Diagnosis and Treatment

Kim

2010

J Korean Neurosurg Soc

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J Korean Neurosurg Soc 48 : [473][474][475][476][477][478][479] 2010 A cervical radiculopathy is the most common symptom of cervical degenerative disease and its natural course is generally favorable. With a precise diagnosis using appropriate tools, the majority of patients will respond well to conservative treatment. Cervical radiculopathy with persistent radicular pain after conservative treatment and progressive or profound motor weakness may require surgery. Options for surgical management are extensive. Each technique has strengths and weaknesses, so the choice will depend on the patient's clinical profile and the surgeon's judgment.

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Risk factors for outcome and complications of dorsal foraminotomy in cervical disc herniation

Cited by 44 publications

References 17 publications

Long-term patient outcomes after posterior cervical foraminotomy: an analysis of 151 cases

Long-term patient outcomes after posterior cervical foraminotomy: an analysis of 151 cases

The characteristic clinical symptoms of C-4 radiculopathy caused by ossification of the posterior longitudinal ligament

Cervical Radiculopathy due to Cervical Degenerative Diseases : Anatomy, Diagnosis and Treatment

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