Anterior cervical foraminotomy for unilateral radicular disease.
METHODS
A clinical series of patients with unilateral radiculopathy treated with the anterior cervical foraminotomy procedure.


OBJECTIVE
To establish procedural techniques and clinical and radiologic outcomes for the anterior cervical foraminotomy procedure.


BACKGROUND
Cervical radiculopathy is typically caused by unilateral disc herniation or uncovertebral osteophytes that compress the ventral aspect of the nerve. Direct removal of a cervical lesion causing radicular symptoms without concomitant fusion seems to be an ideal treatment in selected patients. The indications for an anterior cervical neural foraminotomy are limited to unilateral radicular symptoms at one or two levels, with minimal neck pain.


METHODS
Twenty-one patients were treated with the anterior cervical neural foraminotomy procedure during a 3-year period with follow-up from 6 to 36 months. There were 13 men and 8 women (age range, 27-58 years). Fourteen patients had symptomatic soft disc herniation, and 7 had uncovertebral osteophytes confirmed by magnetic resonance imaging and/or myelogram and computed tomography. Sixteen patients had a single anterior cervical neural foraminotomy, and 5 had procedures at adjacent levels.


RESULTS
Nineteen patients (91%) had improved or resolved radicular symptoms, and 2 (9%) had persistent radicular symptoms necessitating further surgery (one two-level anterior cervical neural discectomy and fusion and one posterior foraminal decompression).


CONCLUSIONS
Patients treated with the anterior cervical neural foraminotomy procedure have equivalent or better outcomes than those who undergo current cervical procedures. It appears to be a good alternative procedure for carefully selected patients with unilateral cervical radiculopathy and avoids a fusion of the disc space.
Johnson
J P
JP
Division of Neurosurgery, Department of Surgery, School of Medicine, University of California at Los Angeles, Los Angeles, California 90095-6901, USA.
Filler
A G
AG
McBride
D Q
DQ
Batzdorf
U
U
D000328:Adult; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009192:Myelography; D019547:Neck Pain / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D010147:Pain Measurement; D011183:Postoperative Complications; D011843:Radiculopathy / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D012086:Reoperation; D013128:Spinal Osteophytosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome