Posterior laminoforaminotomy in the treatment of lateralcervical herniated disc and foraminal stenosis

Abstract

Posterior laminoforaminotomy is applied to selected patients with a low complication rate. The advantages of this surgery are suitable visualization of the nerve root, preserved motion of the operated segment, avoidance of cervical instability, and a decrease in the length of hospital stay.

Perspective: Cervical laminoforaminotomy (CLF) is safer than anterior cervical diskectomy/fusion (ACDF) for lateral cervical disease

“…CLF and its' minimally invasive, microendoscopic, and microdiskectomy variants offer greater safety, major pros with few cons, and decreased costs vs. ACDF for patients with lateral/foraminal cervical disc disease and/or spondylosis [Table 1]. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]…”

“…ree studies documented good/excellent postoperative outcomes with limited reports of adverse events following open CLF [Table 1]. [13][14][15] Yilmaz (2016) et al found that performing 83 open CLF to address posterolateral soft discs or foraminal stenosis resulted in 66 excellent and 13 good outcomes (Odom's Criteria); additionally, 79 (95%) showed improvement in postoperative radicular complaints, with just two adverse events (i.e., AE: 1 dural tear, and one wrong level surgery) [Table 1]. [13] Further pros for CLF included; better operative exposure to limit perioperative neural injuries, a shortened LOS, and greater preservation of stability (i.e., avoidance of fusion 1].…”

“…[13][14][15] Yilmaz (2016) et al found that performing 83 open CLF to address posterolateral soft discs or foraminal stenosis resulted in 66 excellent and 13 good outcomes (Odom's Criteria); additionally, 79 (95%) showed improvement in postoperative radicular complaints, with just two adverse events (i.e., AE: 1 dural tear, and one wrong level surgery) [Table 1]. [13] Further pros for CLF included; better operative exposure to limit perioperative neural injuries, a shortened LOS, and greater preservation of stability (i.e., avoidance of fusion 1]. [14] When Yoo et al (2017) evaluated the overall outcomes for 27 patients undergoing open CLF for soft disc herniations vs. 20 for lateral/foraminal stenosis, they found both groups exhibited 92.6% excellent and 7.4% good outcomes (Odom's Criteria), with better results recorded for those with soft discs [Table 1].…”

“…found that performing 83 open CLF to address posterolateral soft discs or foraminal stenosis resulted in 66 excellent and 13 good outcomes (Odom’s Criteria); additionally, 79 (95%) showed improvement in postoperative radicular complaints, with just two adverse events (i.e., AE: 1 dural tear, and one wrong level surgery) [ Table 1 ]. [ 13 ] Further pros for CLF included; better operative exposure to limit perioperative neural injuries, a shortened LOS, and greater preservation of stability (i.e., avoidance of fusion). Performing 35 open keyhole (KH) CLF to address 21 lateral/foraminal soft discs and 14 with foraminal osteophytes, Yolas et al .…”

“…Cervical laminoforaminotomy (CLF), whether performed open, minimally invasively (MI), or microendoscopically (ME) for lateral/foraminal cervical disc disease, are safer than anterior cervical diskectomy/fusion (ACDF) [Table 1]. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Notably, ACDF risks uniquely include, carotid artery or jugular vein injuries, esophageal tears, dysphagia, tracheal injuries, and recurrent laryngeal nerve injuries not posed by CLF. Further, CLF vs. ACDF offer marked reductions in the frequency of vertebral artery injuries, cord/nerve root deficits, spinal instability, dural tears (DT), tissue damage, operative time, estimated blood loss (EBL), adjacent segment disease, length of stay, and cost.…”