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Minimally Invasive Posterior Cervical Foraminotomy and Discectomy

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The Resident's Guide to Spine Surgery

Abstract

Cervical radiculopathy is a common problem typically encountered by spinal surgeons. It is defined as a syndrome of pain and/or sensorimotor deficits due to compression of a cervical nerve root. Common causes of the syndrome include cervical disc disease, spondylosis, instability, trauma, and tumors. Most patients (75–90%) with cervical radiculopathy will have symptomatic improvement with conservative, nonoperative management, which includes treatments such as physical therapy, cervical traction, and epidural steroid injections. However, when patients either fail conservative management or begin to experience progressive neurologic deficits, surgical intervention is warranted. The two most common procedures are anterior cervical discectomy and fusion (ACDF) and posterior cervical foraminotomy (PCF).

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References

  1. Caridi JM, Pumberger M, Hughes AP. Cervical radiculopathy: a review. HSS J. 2011;7(3):265–72.

    Article  Google Scholar 

  2. Scoville W, Whitcomb B, McLaurin R. The cervical ruptured disc: report of 115 operative cases. Trans Am Neurol Assoc. 1951;(56):222–4.

    Google Scholar 

  3. Frykholm R. Cervical nerve root compression resulting from disc degeneration and root sleeve fibrosis. Acta Chir Scand. 1951;(Suppl 160).

    Google Scholar 

  4. Smith GW, Robinson RA. The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion. J Bone Joint Surg Am. 1958;40-A(3):607–24.

    Article  CAS  Google Scholar 

  5. Cloward RB. The anterior approach for removal of ruptured cervical disks. J Neurosurg. 1958;15(6):602–17.

    Article  CAS  Google Scholar 

  6. Heary RF, Ryken TC, Matz PG, Anderson PA, Groff MW, Holly LT, et al. Cervical laminoforaminotomy for the treatment of cervical degenerative radiculopathy. J Neurosurg Spine. 2009;11(2):198–202.

    Article  Google Scholar 

  7. Roh SW, Kim DH, Cardoso AC, Fessler RG. Endoscopic foraminotomy using MED system in cadaveric specimens. Spine (Phila Pa 1976). 2000;25(2):260–4.

    Article  CAS  Google Scholar 

  8. Burke TG, Caputy A. Microendoscopic posterior cervical foraminotomy: a cadaveric model and clinical application for cervical radiculopathy. J Neurosurg. 2000;93(1 Suppl):126–9.

    CAS  PubMed  Google Scholar 

  9. Adamson TE. Microendoscopic posterior cervical laminoforaminotomy for unilateral radiculopathy: results of a new technique in 100 cases. J Neurosurg. 2001;95(1 Suppl):51–7.

    CAS  PubMed  Google Scholar 

  10. Fessler RG, Khoo LT. Minimally invasive cervical microendoscopic foraminotomy: an initial clinical experience. Neurosurgery. 2002;51(5 Suppl):S37–45.

    PubMed  Google Scholar 

  11. Epstein NE. A review of laminoforaminotomy for the management of lateral and foraminal cervical disc herniations or spurs. Surg Neurol. 2002;57(4):226–33; discussion 233–4.

    Article  Google Scholar 

  12. Dodwad SJ, Dodwad SN, Prasarn ML, Savage JW, Patel AA, Hsu WK. Posterior cervical foraminotomy: indications, technique, and outcomes. Clin Spine Surg. 2016;29(5):177–85.

    Article  Google Scholar 

  13. Ahn J, Tabaraee E, Bohl DD, Singh K. Minimally invasive posterior cervical foraminotomy. J Spinal Disord Tech. 2015;28(8):295–7.

    Article  Google Scholar 

  14. Gala VC, O’Toole JE, Voyadzis JM, Fessler RG. Posterior minimally invasive approaches for the cervical spine. Orthop Clin North Am. 2007;38(3):339–49; abstract v.

    Article  Google Scholar 

  15. Harrop JS, Silva MT, Sharan AD, Dante SJ, Simeone FA. Cervicothoracic radiculopathy treated using posterior cervical foraminotomy/discectomy. J Neurosurg. 2003;98(2 Suppl):131–6.

    PubMed  Google Scholar 

  16. Bydon M, Mathios D, Macki M, de la Garza-Ramos R, Sciubba DM, Witham TF, et al. Long-term patient outcomes after posterior cervical foraminotomy: an analysis of 151 cases. J Neurosurg Spine. 2014;21(5):727–31.

    Article  Google Scholar 

  17. Kerry G, Hammer A, Ruedinger C, Ranaie G, Steiner HH. Microsurgical posterior cervical foraminotomy: a study of 181 cases. Br J Neurosurg. 2017;31(1):39–44.

    Article  Google Scholar 

  18. Jagannathan J, Sherman JH, Szabo T, Shaffrey CI, Jane JA. The posterior cervical foraminotomy in the treatment of cervical disc/osteophyte disease: a single-surgeon experience with a minimum of 5 years’ clinical and radiographic follow-up. J Neurosurg Spine. 2009;10(4):347–56.

    Article  Google Scholar 

  19. Lawton CD, Smith ZA, Lam SK, Habib A, Wong RH, Fessler RG. Clinical outcomes of microendoscopic foraminotomy and decompression in the cervical spine. World Neurosurg. 2014;81(2):422–7.

    Article  Google Scholar 

  20. Skovrlj B, Gologorsky Y, Haque R, Fessler RG, Qureshi SA. Complications, outcomes, and need for fusion after minimally invasive posterior cervical foraminotomy and microdiscectomy. Spine J. 2014;14(10):2405–11.

    Article  Google Scholar 

  21. McAnany SJ, Kim JS, Overley SC, Baird EO, Anderson PA, Qureshi SA. A meta-analysis of cervical foraminotomy: open versus minimally-invasive techniques. Spine J. 2015;15(5):849–56.

    Article  Google Scholar 

  22. Kim KT, Kim YB. Comparison between open procedure and tubular retractor assisted procedure for cervical radiculopathy: results of a randomized controlled study. J Korean Med Sci. 2009;24(4):649–53.

    Article  Google Scholar 

  23. Clark JG, Abdullah KG, Steinmetz MP, Benzel EC, Mroz TE. Minimally invasive versus open cervical foraminotomy: a systematic review. Global Spine J. 2011;1(1):9–14.

    Article  Google Scholar 

  24. Lubelski D, Healy AT, Silverstein MP, Abdullah KG, Thompson NR, Riew KD, et al. Reoperation rates after anterior cervical discectomy and fusion versus posterior cervical foraminotomy: a propensity-matched analysis. Spine J. 2015;15(6):1277–83.

    Article  Google Scholar 

  25. Ruetten S, Komp M, Merk H, Godolias G. A new full-endoscopic technique for cervical posterior foraminotomy in the treatment of lateral disc herniations using 6.9-mm endoscopes: prospective 2-year results of 87 patients. Minim Invasive Neurosurg. 2007;50(4):219–26.

    Article  CAS  Google Scholar 

  26. Mansfield HE, Canar WJ, Gerard CS, O’Toole JE. Single-level anterior cervical discectomy and fusion versus minimally invasive posterior cervical foraminotomy for patients with cervical radiculopathy: a cost analysis. Neurosurg Focus. 2014;37(5):E9.

    Article  Google Scholar 

  27. Alvin MD, Lubelski D, Abdullah KG, Whitmore RG, Benzel EC, Mroz TE. Cost-utility analysis of anterior cervical discectomy and fusion with plating (ACDFP) versus posterior cervical foraminotomy (PCF) for patients with single-level cervical radiculopathy at 1-year follow-up. Clin Spine Surg. 2016;29(2):E67–72.

    Article  Google Scholar 

  28. Faught RW, Church EW, Halpern CH, Balmuri U, Attiah MA, Stein SC, et al. Long-term quality of life after posterior cervical foraminotomy for radiculopathy. Clin Neurol Neurosurg. 2016;142:22–5.

    Article  Google Scholar 

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Passer, J.Z., Manoochehri, S., Kim, BS. (2020). Minimally Invasive Posterior Cervical Foraminotomy and Discectomy. In: O'Brien, J., Kalantar, S., Drazin, D., Sandhu, F. (eds) The Resident's Guide to Spine Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-20847-9_8

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  • DOI: https://doi.org/10.1007/978-3-030-20847-9_8

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-20846-2

  • Online ISBN: 978-3-030-20847-9

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