Anterior cervical microforaminotomy for spondylotic cervical myelopathy: part 2.
OBJECTIVE
Anterior microforaminotomy for spondylotic cervical myelopathy is reported with surgical results.


METHODS
A retrospective study was performed for 40 patients with spondylotic cervical myelopathy who had been surgically treated with anterior microforaminotomy at the University of Pittsburgh between April 1994 and June 1999. Age ranged from 32 to 74 years (median, 51 yr). Twenty-eight patients were men, and 12 were women. All had undergone magnetic resonance imaging (MRI) scans preoperatively. All underwent MRI scans and dynamic roentgenograms 6 weeks after the operation. The duration of follow-up ranged from 24 months to 86 months (median, 42 mo).


RESULTS
Twenty-eight patients (70%) had radiculopathy in addition to their myelopathy. Single-level operations were performed in 13 patients (32.5%), two-level operations in 19 patients (47.5%), three-level operations in 5 patients (12.5%), and four-level operations in 3 patients. Eleven patients (27.5%) had excellent results, 21 patients (52.5%) had good results, and 8 patients (20%) had unchanged results 6 weeks after the operation. Thirty-five patients (87.5%) were discharged the day of or the day after their operation. In all patients, MRI scans revealed good anatomic decompression, and dynamic roentgenograms revealed good stability. Postoperative complications included temporary deltoid weakness in one patient and temporary voice fatigue in another patient. In a final survey of 30 patients, 16 patients (53.3%) experienced excellent results, 11 patients (36.6%) experienced good results, and 3 patients (10%) experienced unchanged results. Final outcome survey with modified Japanese Orthopedic Association score is reported in 25 patients.


CONCLUSIONS
Anterior microforaminotomy provided good to excellent surgical results in 80% of the patients with minimal morbidities 6 weeks after the operation and in 90% of the patients at long-term follow-up. Spinal stability was well maintained in all patients.
Jho
Hae-Dong
HD
Center for Minimally Invasive Neurosurgery, Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. DrJho@DrJho.com
Kim
Myung-Hyun
MH
Kim
Woo-Kyung
WK
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery / Q000009:adverse effects; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects; D011859:Radiography; D012189:Retrospective Studies; D013118:Spinal Cord Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D013128:Spinal Osteophytosis / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging; D016896:Treatment Outcome