Comparison of biomechanical response to surgical procedures used for cervical radiculopathy: posterior keyhole foraminotomy versus anterior foraminotomy and discectomy versus anterior discectomy with fusion.
The objective of this study was to compare the change in flexibility of C5-C6 caused by three procedures using a three-dimensional nonlinear finite element model: posterior foraminotomy (keyhole procedure), anterior foraminotomy with discectomy, and anterior discectomy with fusion. The keyhole procedure produced a minor increase in motion. The anterior foraminotomy and discectomy produced one to two times greater motion. Anterior discectomy with fusion produced 50% to 100% reduction in motion. The posterior keyhole foraminotomy has a much lesser effect on the stability of the cervical spine segment than does an anterior procedure, and fusion is a requisite part of the anterior decompression procedure.
Department of Orthopedic Surgery, Rush-Presbyterian-St.Luke's Medical Center, Chicago, Illinois 60612, USA.
B H
BH
Chen
R N
RN
Natarajan
H S
HS
An
G B
GB
Andersson
D001696:Biomechanical Phenomena; D002574:Cervical Vertebrae / Q000502:physiology / Q000601:surgery; D017586:Diskectomy / Q000379:methods*; D006801:Humans; D008954:Models, Biological; D009068:Movement; D017711:Nonlinear Dynamics; D011843:Radiculopathy / Q000503:physiopathology* / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D014102:Torsion Abnormality