title: Cervical cord decompression using extended anterior cervical foraminotomy technique.
abstract: OBJECTIVE
  At present, gold-standard technique of cervical cord decompression is surgical decompression and fusion. But, many complications related cervical fusion have been reported. We adopted an extended anterior cervical foraminotomy (EACF) technique to decompress the anterolateral portion of cervical cord and report clinical results and effectiveness of this procedure.
  
  
  METHODS
  Fifty-three patients were operated consecutively using EACF from 2008 to 2013. All of them were operated by a single surgeon via the unilateral approach. Twenty-two patients who exhibited radicular and/or myelopathic symptoms were enrolled in this study. All of them showed cervical cord compression in their preoperative magnetic resonance scan images.
  
  
  RESULTS
  In surgical outcomes, 14 patients (64%) were classified as excellent and six (27%), as good. The mean difference of cervical cord anterior-posterior diameter after surgery was 0.92 mm (p<0.01) and transverse area was 9.77 mm(2) (p<0.01). The dynamic radiological study showed that the average post-operative translation (retrolisthesis) was 0.36 mm and the disc height loss at the operated level was 0.81 mm. The change in the Cobb angle decreased to 3.46, and showed slight kyphosis. The average vertebral body resection rate was 11.47%. No procedure-related complications occurred. Only one patient who had two-level decompression needed anterior fusion at one level as a secondary surgery due to postoperative instability.
  
  
  CONCLUSIONS
  Cervical cord decompression was successfully performed using EACF technique. This procedure will be an alternative surgical option for treating cord compressing lesions. Long-term follow-up and a further study in larger series will be needed.
authors.affiliation: Department of Neurosurgery, Konyang University Hospital, Daejon, Koera.
authors.forename: Sung-Duk
authors.initials: SD
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Konyang University Hospital, Daejon, Koera. ; Department of Neurosurgery, Teun Teun Hospital, Daejon, Korea.
authors.forename: Ho-Gyun
authors.initials: HG
authors.lastname: Ha
authors.affiliation: Department of Neurosurgery, Konyang University Hospital, Daejon, Koera.
authors.forename: Cheol-Young
authors.initials: CY
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Konyang University Hospital, Daejon, Koera.
authors.forename: Hyun-Woo
authors.initials: HW
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Konyang University Hospital, Daejon, Koera.
authors.forename: Chul-Ku
authors.initials: CK
authors.lastname: Jung
authors.affiliation: Department of Neurosurgery, Konyang University Hospital, Daejon, Koera.
authors.forename: Jong Hyun
authors.initials: JH
authors.lastname: Kim
keywords: Anterior cervical foraminotomy; Cervical myelopathy; Cervical spondylosis; Spinal cord compression