Midterm Follow-up Results of Anterior Cervical Microforaminotomy

ABSTRACT

OBJECTIVE: We have previously reported excellent early clinical results of anterior cervical microforaminotomy(ACMF) for patients who have cervical radiculopathy from either disc herniation or foraminal stenosis. ACMF is being accepted as a minimal invasive functional spinal surgery, but their long-term outcome is unknown. The goal of this study is to evaluate the midterm clinical and radiological results of ACMF. METHODS: We had undertaken a questionnaire survey and retrospective analysis of 42 patients with cervical radiculopathy who had undergone ACMF from 1998 to 2001. Clinical data from 33 patients(one-level operation in 20 patients, two-level in 13 patients) and radiological data from 21 patients were analysed. RESULTS: Thirty-three patients answered for the questionnaires. Mean follow-up was 48 months(ranged from 26 to 64 months). The surgical outcome was excellent in 18 patients(54.6%) and good in 11 patients(33.3%). One patient showed poor outcome, but there was no case of recurrence, reoperation or additive surgery. Twenty-four patients(79%) satisfied with the results of their surgery. On the average, the loss of disc height was 1.02mm(18% of preoperative disc height), average increase of displacement was 0.83mm, decrease of sagittal plane angulation was 2.03 degrees. All the patients maintained stability during follow-up period. CONCLUSION: In the midterm, ACMF appears to be safe and effective method for the treatment of cervical radiculopathy. To prevent disc height loss and retrolisthesis, skilled disc-preserving technique of ACMF is required and modified technique preserving anterior part of uncovertebral joint may be advantageous.