Radiologic Changes of Operated and Adjacent Segments after Anterior Cervical Microforaminotomy

OBJECTIVE: Anterior cervical microforaminotomy (ACMF) is a motion-preserving surgical procedure. The purpose of this study is to assess radiologic changes of operated and adjacent segments after ACMF. METHODS: We retrospectively reviewed 52 patients who underwent ACMF between 1998 and 2008. From X-ray film-based changes, disc height and sagittal range of motion (ROM) of operated and adjacent segments were compared at preoperative and last follow-up periods. Radiological degeneration of both segments was analyzed as well. RESULTS: The mean follow-up period was 48.2 months. There were 78 operated, 52 upper adjacent, and 38 lower adjacent segments. There were statistically significant differences in the ROM and disc height of operated segment between preoperative and last follow-up periods. However, there were no statistically significant differences in the ROM and disc height of adjacent segment between both periods. Radiological degenerative changes of operated segments were observed in 30%. That of adjacent segments was observed in 11 and 11% at upper and lower segments, respectively. CONCLUSION: After mean 4-year follow-up periods, there were degenerative changes of operated segments. However, ACMF preserved motion and prevented degenerative changes of adjacent segments.

Clinical Results of Microsurgical Anterior Foraminotomy for Cervical Radiculopathy

OBJECTIVE: The authors present the clinical and radiologic outcomes of microsurgical anterior foraminotomy in 36 cases of cervival radiculopathy. METHODS: Thirty-six patients were treated with anterior cervical foraminotomy between January 1998 and June 2002. There were 13 men and 23 women(age range, 34-74 years). Twenty-nine had symptomatic soft disc herniation and 7 had uncovertebral osteophytes confirmed by magnetic resonance imaging and computed tomography. Thirty-one patients had single anterior cervical microforaminotomy and five had procedures at adjacent levels. RESULTS: Good or excellent result were obtained in 75% of the patients. On roentgenographic examination, the height of intervertebral space was maintained at twenty-one levels(51%) and was decreased at seventeen levels(42%). Two patients who underwent anterior cervical microforaminotomy developed kyphosis of the cervical spine and one patient developed instability of the cervical spine. CONCLUSION: Anterior cervical foraminotomy appears to be a good alternative procedure for carefully selected patients with unilateral cervical radiculopathy and avoids a fusion of the disc space.

Comparison of Surgical Results between Anterior Cervical Interbody Fusion(ACIF) and Microsurgical Anterior Cervical Foraminotomy(MACF) for Cervical Disc Herniation

OBJECTIVE: Until recently anterior cervical discectomy with or without bone fusion has been widely used for the treatment of cervical disc herniation. After introduction of the microsurgical anterior cervical foraminotomy(MACF), there has been a tendency to preserve the functioning motion segment. But some worried about technical difficulties and complications such as injury to the vertebral artery. This study is to compare the short-term results of anterior cervical interbody fusion(ACIF) with that of MACF. METHODS: We reviewed medical records of 40 patients, 20 patients of ACIF performed during 30 months and 20 patients of MACF performed during 8 months. RESULTS: The average length of stay in the hospital was longer in cases of ACIF(12.9 days) than in those of MACF(7.1 days). The rate of the symptom relief within 1 day was higher in MACF(90%) than in ACIF(70%). The overall satisfaction experienced by the patients after surgery was higher in MACF(85%) than in ACIF(70%). The rate of the recommendation for surgical treatment to other people was higher in MACF(85%) than in ACIF(65%). But the differences were not significant statistically. The major complication was bone donor site pain in ACIF cases and neck and shoulder pain in MACF cases. CONCLUSION: This data demonstrate that MACF is of value in the treatment of cervical disc herniation, which can be performed with safety and good outcome like conventional ACIF.