Posterior Cervical Foraminotomy: An Alternative to Anterior Cervical Discectomy and Fusion

Objective: Is to perform a detailed retrospective assessment of the Safety, efficacy and complications of posterior microscopic cervical foraminotomy for treatment of cervical degenerative radiculopathy compared to published results of ACDF approach. Methods: A retrospective analysis was conducted on 31 patients with unilateral cervical radiculopathy. Only patients with radiculopathy caused by single or double level cervical degenerative disc disease were included in the study. Degenerative disc disease was confirmed by concordant clinical and radiological data. Only cases refractory to non-surgical measures for 3 months at least were admitted and operated at Kasr El-Ainy university hospitals between March 2009 and August 2010. Outcomes were assessed by using the Odom's criteria. Patients were followed-up on an outpatient basis for periods ranging from 6 months to 2 years. Results: Average age of presentation was 44.1 years, male to female ratio was 1.8:1 and average duration of symptoms was 51.4 weeks. 21 cases had left sided radiculopathy, 10 cases had right sided affection. The most common presenting symptom after brachialgia (100%) was neck pain (87%); most common sign was hyporeflexia (67%). Most common operated level was C5-6 (50%). Excellent and good outcomes were obtained in 87% of the patients. The mean follow-up period was 14.5 months with no complications, recurrence, instability or progressive kyphosis. Conclusion: Microscopic posterior cervical foraminotomy is a safe and effective approach for treatment of cervical radiculopathy resulting from foraminal hard and soft disc pathologies with comparable results to the ACDF approach.