title: Minimally invasive cervical foraminotomy and diskectomy for laterally located soft disk herniation.
abstract: OBJECTIVE
  The posterior cervical foraminotomy and diskectomy (PCD) is a traditional surgical technique for patients with laterally located soft-disk herniation. Recently, tubular retractor-assisted posterior foraminotomy and diskectomy (MTPF) and posterior percutaneous endoscopic cervical foraminotomy and diskectomy (P-PECD) have been introduced, but a comparative study has not yet been performed.
  
  
  METHODS
  Patients with foraminal soft-disk herniation and a follow-up period of >2 years were retrospectively reviewed; 22 patients underwent a MTPF and 22 patients underwent a P-PECD. The primary end-point was an improvement of arm pain more than 4.3. The clinical parameters (age, sex, disability index, neck and arm pain), radiological parameters (cervical curvature, segmental angle, anterior-/posterior-disk height and amount of facet joint removal) preoperatively and at postoperative month 24 and the surgical methods were considered as co-variates.
  
  
  RESULTS
  Successful outcome was achieved in 19/22 (87%) of the patients after both MTPF and a P-PECD. Preoperative SA showed trend (P = 0.08; OR 1.2; 95% CI 0.98-1.4) and the cut-off SA was 1.45° (sensitivity 80%, specificity 73%). The length of the facet joint's removal was 0.02-2.49 mm (0.1-15.2%) with no difference between the MTPF and P-PECD. The surgical method was not a significant factor.
  
  
  CONCLUSIONS
  For patients with foraminal soft-disk herniation, either MTPF or P-PECD, may be regarded as an alternative options to open surgery. Preoperative kyphotic SA (cut-off value 1.45°) seemed to be associated with poor outcome and this may be considered in selecting surgical methods.
authors: Department of Neurosurgery, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-gu, Seoul, 110-744, Republic of Korea.|Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea.|Clinical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
authors: Chi Heon
authors: CH
authors: Kim
authors: Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Republic of Korea.
authors: Kyoung-Tae
authors: KT
authors: Kim
authors: Department of Neurosurgery, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-gu, Seoul, 110-744, Republic of Korea. chungc@snu.ac.kr.|Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea. chungc@snu.ac.kr.|Clinical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea. chungc@snu.ac.kr.|Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea. chungc@snu.ac.kr.
authors: Chun Kee
authors: CK
authors: Chung
authors: Department of Neurosurgery, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-gu, Seoul, 110-744, Republic of Korea.|Department of Neurosurgery, Seoul National University Boramae Hospital, Seoul, Republic of Korea.
authors: Sung Bae
authors: SB
authors: Park
authors: Department of Neurosurgery, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-gu, Seoul, 110-744, Republic of Korea.|Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea.
authors: Seung Heon
authors: SH
authors: Yang
authors: Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea.
authors: Sung Mi
authors: SM
authors: Kim
authors: Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Republic of Korea.
authors: Joo-Kyung
authors: JK
authors: Sung
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000601:surgery*; D017586:Diskectomy / Q000379:methods*; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D059526:Foraminotomy / Q000379:methods*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D064232:Visual Analog Scale
keywords: Cervical vertebrae; Disk; Endoscopes; Percutaneous; Tubular retractor