A retrospective study was conducted on 67 patients undergoing posterior cervical foraminotomy (PCF) for unilateral intraforaminal soft and hard disc disease. Neurologic impairment, employment, and severity of associated signs were assessed preoperatively and at a 3.1-year average follow-up (range, 1.5-7 years). Diminution or complete disappearance of radicular symptoms was observed in 62 cases (93%), 3 months to 3 years after surgery. Minimal neurologic deficits persisted in 5 cases (7%). Neck pain improved in 62 cases, remained unchanged in three, and progressed in two cases with severe preoperative deficits. Fifty-three patients (79%) returned to their previous occupation; only seven (10%) retired prematurely on the basis of disc disease alone. Based on Prolo's functional economic outcome rating scale, 60 patients (90%) showed excellent economic outcome. Posterior cervical foraminotomy is an efficient means of decompressing lateral spinal roots compromised by soft disk herniations or osteophytic spurs, without the risk of an anterior approach with or without fusion. Careful patient selection and microsurgical technique are essential in obtaining consistent, excellent results. Additionally, the recent trend toward minimally invasive techniques and key-hole operations in neurosurgery and other specialisations favours the posterior approach.

A patient with a tentorial dural AV fistula causing atypical trigeminal neuralgia (TN) successfully treated by embolization is reported. The patient developed persisting throbbing facial pain in the distribution of the second and third division of the right trigeminal nerve (V2,V3) after a history of typical neuralgia for one year, preceded by a two month spell of TN 6 years previously and accompanied by right-sided pulsatile tinnitus for 10 years. The patient's mother, brother and sister were also said to be affected by typical trigeminal neuralgia.A right-sided dilated vein of Rosenthal due to a dural AV fistula fed by branches of the meningeal, occipital and meningo-hypophyseal trunk of the internal carotid artery was thought to cause trigeminal nerve compression. Complete resolution of symptoms after partial intra-arterial embolization of the main feeding arteries with N-butyroacrylate is described.

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