Autohrs: Son S et al
World Neurosurgery Sep 2018
BACKGROUND Microscopic anterior cervical foraminotomy (MACF) is a surgical technique for unilateral cervical radiculopathy that preserves segmental motion and avoids adjacent segmental degeneration, but little is known of its long-term outcomes.
METHODS A retrospective minimum 10-year follow-up study was conducted on patients treated by one surgeon. Clinical outcomes were assessed using a visual analogue scale (VAS) of neck and arm pain, neck disability index (NDI), and Odom’s criteria. Surgical outcomes were assessed using additional procedure rates. Radiological outcomes were estimated by measuring disc heights, segmental angles, and range of motion (ROM) at the surgical level and adjacent segments, and so on.
RESULTS Of the 94 patients that underwent MACF between January 2000 and December 2004 by one surgeon, 69 were enrolled in this study. Median follow-up period was 11.9 years (range, 10.0-14.5 years). VASs for neck or arm pain and NDI improved significantly during follow-up period (p<0.001). Also, according to Odom’s criteria, an excellent or good outcome was achieved in 62 patients (89.9%) at final follow-up. An additional procedure was performed in 10 patients (14.5%) for symptom recurrence during follow-up period. The only risk factor found to be related to the need for an additional procedure was a small preoperative ROM at the surgical level (p=0.018). Although mean disc height at the surgical level decreased significantly (from 6.23±1.10 to 5.17±1.12 mm, p=0.004), adjacent discs were not significantly affected.
CONCLUSION Although some radiological results have shortcomings, the results of this study suggest MACF has favorable long-term outcomes.