title: A single neurosurgical center's experience of the resolution of cervical radiculopathy after dorsal foraminotomy and ventral discectomy.
abstract: Monosegmental cervical disc herniation can be removed either by dorsal foraminotomy and sequesterectomy (Frykholm's method) or by a ventral approach with extensive removal of the affected disc with subsequent segmental fusion (modified Cloward's method). The choice of method largely depends on the surgeon's individual preference and experience. We evaluated the neurological outcomes of both surgical methods in a retrospective series of 100 consecutive patients (50 male, 50 female; mean age=47.7 years) who underwent surgery within a 3-year period. Fifty-one patients (30 male, 21 female; mean age=50.1 years) underwent a dorsal foraminotomy and 49 patients (20 male, 29 female; mean age=45.3 years) underwent surgery by the ventral approach with consecutive segmental fusion. We identified demographic data and analysed the postoperative neurological performance (motor and sensory activity) and the resolution of the radiating and local pain during the in-hospital stay. Patients in the Cloward Group recovered significantly better from cervicobrachialgia (p=0.02), neck pain (p=0.01) and sensory deficits (p=0.003). Furthermore, the Cloward Group showed a trend towards better outcomes for paresis. Complete removal of the affected cervical disc via a ventral approach and segmental fusion results in a superior neurological performance in the short-term compared to a dorsal foraminotomy and nerve root decompression by sequestrectomy. However, assessment of the long-term outcome is required and further studies are required to confirm our results.
authors.affiliation: Department of Neurosurgery, University of Regensburg Medical Center, Franz-Josef-Strauss Allee 11, 93053 Regensburg, Germany. karl-michael.schebesch@klinik.uni-regensburg.de
authors.forename: Karl-Michael
authors.initials: KM
authors.lastname: Schebesch
authors.forename: Ruth
authors.initials: R
authors.lastname: Albert
authors.forename: Petra
authors.initials: P
authors.lastname: Schödel
authors.forename: Martin
authors.initials: M
authors.lastname: Proescholdt
authors.forename: Max
authors.initials: M
authors.lastname: Lange
authors.forename: Alexander
authors.initials: A
authors.lastname: Brawanski
mesh_terms: D000328:Adult; D000368:Aged; D017586:Diskectomy / Q000009:adverse effects*; D005260:Female; D059526:Foraminotomy / Q000009:adverse effects*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011843:Radiculopathy / Q000209:etiology* / Q000601:surgery*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome