title: Cervical laminoforaminotomy for radiculopathy: Symptomatic and functional outcomes in a large cohort with long-term follow-up.
abstract: BACKGROUND
  The efficacy and safety of cervical laminoforaminotomy (FOR) in the treatment of cervical radiculopathy has been demonstrated in several series with follow-up less than a decade. However, there is little data analyzing the relative effectiveness of FOR for radiculopathy due to soft disc versus osteophyte disease. In the present study, we review our experience with FOR in a single-center cohort, with long-term follow-up.
  
  
  METHODS
  We examined the charts of patients who underwent 1085 FORs between 1990 and 2009. A cohort of these patients participated in a telephone interview designed to assess improvement in symptoms and function.
  
  
  RESULTS
  A total of 338 interviews were completed with a mean follow-up of 10 years. Approximately 90% of interviewees reported improved pain, weakness, or function following FOR. Ninety-three percent of patients were able to return to work after FOR. The overall complication rate was 3.3%, and the rate of recurrent radiculopathy requiring surgery was 6.2%. Soft disc subtypes compared to osteophyte disease by operative report were associated with improved symptoms (P < 0.05). The operative report of these pathologic subtypes was associated with the preoperative magnetic resonance imaging (MRI) interpretation (P < 0.001).
  
  
  CONCLUSIONS
  These results suggest that FOR is a highly effective surgical treatment for cervical radiculopathy with a low incidence of complications. Radiculopathy due to soft disc subtypes may be associated with a better prognosis compared to osteophyte disease, although osteophyte disease remains an excellent indication for FOR.
authors.affiliation: Department of Neurosurgery, Penn State Hershey Medical Center, 30 Hope Drive, Hershey, PA USA.
authors.forename: Ephraim W
authors.initials: EW
authors.lastname: Church
authors.affiliation: University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA USA.
authors.forename: Casey H
authors.initials: CH
authors.lastname: Halpern
authors.affiliation: University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA USA.
authors.forename: Ryan W
authors.initials: RW
authors.lastname: Faught
authors.affiliation: University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA USA.
authors.forename: Usha
authors.initials: U
authors.lastname: Balmuri
authors.affiliation: University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Attiah
authors.affiliation: University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA USA.
authors.forename: Sharon
authors.initials: S
authors.lastname: Hayden
authors.affiliation: University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA USA.
authors.forename: Marie
authors.initials: M
authors.lastname: Kerr
authors.affiliation: University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA USA.
authors.forename: Eileen
authors.initials: E
authors.lastname: Maloney-Wilensky
authors.affiliation: University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA USA.
authors.forename: Janice
authors.initials: J
authors.lastname: Bynum
authors.affiliation: University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA USA.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Dante
authors.affiliation: University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA USA.
authors.forename: William C
authors.initials: WC
authors.lastname: Welch
authors.affiliation: University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA USA.
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Simeone
keywords: Cervical radiculopathy; laminoforaminotomy; posterior cervical foraminotomy; surgical outcomes