Feasibility of Posterior Cervical Foraminotomy for Adjacent Segmental Disease after Anterior Cervical Fusion

Kim, Hyun Jun; Kang, Min Sung; Lee, Sang Ho; Park, Chan Hong; Chung, Seok Won; Shin, Yong Hwan; Lee, Shin Young; Park, Eun Soo

doi:10.3340/jkns.2020.0033

Cited by 3 publications

(1 citation statement)

References 23 publications

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“…Cervical spinal surgery is recommended for patients with cervical radiculopathy and cervical central stenosis when nonsurgical treatment is ineffective [1][2][3][4]. Current surgical options include anterior cervical discectomy fusion (ACDF), artificial…”

Section: Introductionmentioning

confidence: 99%

Overview and Prevention of Complications During Full-Endoscopic Cervical Spine Surgery

Kim,

Park

et al. 2023

J Minim Invasive Spine Surg Tech

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Objective: Posterior full-endoscopic cervical foraminotomy/discectomy (PECF) is used to treat medically intractable cervical radiculopathy. PECF has many potential advantages; however, despite its minimally invasive nature, complications of PECF are possible, including hemorrhage, infection, injury to neural tissue, damage to the facet joint and musculature, loss of cervical lordosis, and subsequent progression to cervical kyphosis. We examined complications following PECF and reviewed the relevant literature.Methods: We retrospectively reviewed 101 patients who underwent PECF for either disc herniation (DH, 59 patients) or foraminal stenosis (FS, 42 patients). After surgery, the patients were encouraged to ambulate and were discharged 2–3 days later without the use of a neck collar. Events occurring during hospitalization were documented in the hospital information system. Patients were followed-up for a mean period of 21±26 months (range, 1–110 months).Results: Clinical parameters improved from 1 month postoperatively and were maintained throughout the follow-up period, with no significant differences between the DH and FS groups (p>0.05). Complications occurred in 14 patients (14%) with no significant difference between the DH (8 of 59, 14%) and FS (6 of 42, 14%) groups (p>0.05). The most common complication was dural tear, followed by motor weakness, sensory changes, hematoma collection, incomplete decompression, reoperation, and wrong-level surgery. Two patients underwent reoperation due to symptomatic hematoma collection and symptom recurrence 3 years postoperatively.Conclusion: The incidence of complications following PECF was 14%. Although most were transient, an understanding of both reported and unreported complications, along with thorough preparation, could reduce the occurrence of PECF-associated complications.

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Section: Introductionmentioning

confidence: 99%

Overview and Prevention of Complications During Full-Endoscopic Cervical Spine Surgery

Kim,

Park

et al. 2023

J Minim Invasive Spine Surg Tech

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Cervical and lumbar foraminotomy for the management of chronic radicular back pain

Speer,

Tanios,

Kodsy

et al. 2024

Decompressive Techniques

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Cervical kinematic change after posterior full-endoscopic cervical foraminotomy for disc herniation or foraminal stenosis

et al. 2023

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Objective Posterior full-endoscopic cervical foraminotomy (PECF) is one of minimally invasive surgical techniques for cervical radiculopathy. Because of minimal disruption of posterior cervical structures, such as facet joint, cervical kinematics was minimally changed. However, a larger resection of facet joint is required for cervical foraminal stenosis (FS) than disc herniation (DH). The objective was to compare the cervical kinematics between patients with FS and DH after PECF. Methods Consecutive 52 patients (DH, 34 vs. FS, 18) who underwent PECF for single-level radiculopathy were retrospectively reviewed. Clinical parameters (neck disability index, neck pain and arm pain), and segmental, cervical and global radiological parameters were compared at postoperative 3, 6, and 12 months, and yearly thereafter. A linear mixed-effect model was used to assess interactions between groups and time. Any occurrence of significant pain during follow-up was recorded during a mean follow-up period of 45.5 months (range 24–113 months). Results Clinical parameters improved after PECF, with no significant differences between groups. Recurrent pain occurred in 6 patients and surgery (PECF, anterior discectomy and fusion) was performed in 2 patients. Pain-free survival rate was 91% for DH and 83% for FS, with no significant difference between the groups (P = 0.29). Radiological changes were not different between groups (P > 0.05). Segmental neutral and extension curvature became more lordotic. Cervical curvature became more lordotic on neutral and extension X-rays, and the range of cervical motion increased. The mismatch between T1-slope and cervical curvature decreased. Disc height did not change, but the index level showed degeneration at postoperative 2 years. Conclusion Clinical and radiological outcomes after PECF were not different between DH and FS patients and kinematics were significantly improved. These findings may be informative in a shared decision-making process.

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Feasibility of Posterior Cervical Foraminotomy for Adjacent Segmental Disease after Anterior Cervical Fusion

Cited by 3 publications

References 23 publications

Overview and Prevention of Complications During Full-Endoscopic Cervical Spine Surgery

Overview and Prevention of Complications During Full-Endoscopic Cervical Spine Surgery

Cervical and lumbar foraminotomy for the management of chronic radicular back pain

Cervical kinematic change after posterior full-endoscopic cervical foraminotomy for disc herniation or foraminal stenosis

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