title: Microsurgical posterior cervical foraminotomy: a study of 181 cases.
abstract: BACKGROUND
  An unsettled controversy over the appropriate surgical approach in cases of cervical radiculopathy caused by degenerative vertebrae and intervertebral discs is still present. The purpose of this study is to examine the efficacy of microsurgical posterior foraminotomy in the treatment of cervical radiculopathy and to find out whether the underlying pathology (soft disc herniation/spondylosis) is of value in predicting long-term outcome after this procedure.
  
  
  METHODS
  Patients, who underwent posterior cervical foraminotomy (PCF) at our department between 2006 and 2013 for unilateral mono-segmental lateral soft disc herniation, or spondylosis, or both, were enrolled in this study. Demographic, clinical and surgical data were retrospectively reviewed. The patients were subsequently interviewed by telephone to identify their long-term outcome. The clinical outcomes were evaluated using Odom's criteria. Descriptive statistics were frequencies and percentage of occurrence for categorical variables and mean and range for continuous variables.
  
  
  RESULTS
  One hundred eighty-one patients were included in this study, with a median follow-up of 58 months (mean 43 months, range 12-96 months). The overall re-operation rate was 7.2% (13 patients); 11 patients (6%) for recurrent root symptoms due to recurrent disc herniation (six patients, 3.3%) and re-stenosis (five patients, 2.8%), one patient (0.55%) for wound infection and one patient (0.55%) for postoperative haematoma. Among the eleven patients who underwent re-operation for recurrent root symptoms there was one patient who additionally had persistent cerebrospinal fluid leak and superficial posterior wound infection. There was no significant difference between lateral soft disc herniation and spondylosis in term of re-operation rate. At discharge, excellent or good outcome was achieved in 89% of patients; the long-term success rate was 97.2% using Odom's criteria.
  
  
  CONCLUSIONS
  Microsurgical PCF is an effective technique for treating lateral spinal root compression. Proper patient selection is obligatory to achieve the best results.
authors.affiliation: a Department of Neurosurgery , Paracelsus Medical University , Nuremberg , Germany.
authors.forename: Ghassan
authors.initials: G
authors.lastname: Kerry
authors.affiliation: a Department of Neurosurgery , Paracelsus Medical University , Nuremberg , Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Hammer
authors.affiliation: a Department of Neurosurgery , Paracelsus Medical University , Nuremberg , Germany.
authors.forename: Claus
authors.initials: C
authors.lastname: Ruedinger
authors.affiliation: a Department of Neurosurgery , Paracelsus Medical University , Nuremberg , Germany.
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Ranaie
authors.affiliation: a Department of Neurosurgery , Paracelsus Medical University , Nuremberg , Germany.
authors.forename: Hans-Herbert
authors.initials: HH
authors.lastname: Steiner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000601:surgery*; D017586:Diskectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000601:surgery; D007405:Intervertebral Disc Displacement / Q000601:surgery; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000628:therapy; D011843:Radiculopathy / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000601:surgery; D013126:Spinal Nerve Roots / Q000601:surgery; D055009:Spondylosis / Q000601:surgery; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult
keywords: Spine surgery; cervical foraminotomy; hard disc; soft disc; spondylosis