Cervical laminoforaminotomy for the treatment of cervical degenerative radiculopathy.
OBJECTIVE
The objective of this systematic review was to use evidence-based medicine to examine the efficacy of posterior laminoforaminotomy in the treatment of cervical radiculopathy.


METHODS
The National Library of Medicine and Cochrane Database were queried using MeSH headings and key words relevant to posterior laminoforaminotomy and cervical radiculopathy. Abstracts were reviewed, and studies meeting inclusion criteria were selected. The guidelines group assembled an evidentiary table summarizing the quality of evidence (Classes I-III). Disagreements regarding the level of evidence were resolved through an expert consensus conference. The group formulated recommendations which contained the degree of strength based on the Scottish Intercollegiate Guidelines network. Validation was done through peer review by the Joint Guidelines Committee of the American Association of Neurological Surgeons/Congress of Neurological Surgeons.


RESULTS
Posterior laminoforaminotomy improves clinical outcome in the treatment of cervical radiculopathy resulting from soft lateral cervical disc displacement or cervical spondylosis with resulting narrowing of the lateral recess. All studies were Class III. The most frequent design flaw involved the lack of utilization of validated outcomes measures. In addition, few historical studies included a detailed preoperative analysis of the patients. As such, the vast majority of studies that included both pre- and postoperative assessments with legitimate outcomes measures have been performed since 1990.


CONCLUSIONS
Posterior laminoforaminotomy is an effective treatment for cervical radiculopathy.
Heary
Robert F
RF
Department of Neurosurgery, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, New Jersey, USA.
Ryken
Timothy C
TC
Matz
Paul G
PG
Anderson
Paul A
PA
Groff
Michael W
MW
Holly
Langston T
LT
Kaiser
Michael G
MG
Mummaneni
Praveen V
PV
Choudhri
Tanvir F
TF
Vresilovic
Edward J
EJ
Resnick
Daniel K
DK
D002574:Cervical Vertebrae / Q000601:surgery*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery; D007796:Laminectomy / Q000379:methods*; D011843:Radiculopathy / Q000601:surgery*; D055009:Spondylosis / Q000601:surgery