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Comparison of Operative Results between Anterior Cervical Microforaminotomy(ACMF) and Anterior Cervical Discectomy and Fusion(ACDF) for One-level Cervical Radiculopathy
Sang-Kuk Lee, M.D., Myung-Hyun Kim, M.D., Do-Sang Cho, M.D., Sung-Kyun Hwang, M.D., Sang-Jin Kim, M.D., Kyu-Man Shin, M.D., Sung-Hak Kim, M.D. and Dong-Been Park, M.D.
Departments of Neurosurgery, College of Medicine, Ewha Womans University, Seoul, Korea
Abstract
Objective
Many different methods have been used to treat cervical disc disease causing radiculopathy. Recently, anterior cervical microforaminotomy(ACMF) was introduced and generally accepted as being a minimally invasive form of functional spinal surgery preserving the motion segment. The goal of this study is to compare the midterm results of anterior cervical microforaminotomy with those of anterior cervical discectomy and fusion(ACDF).
Methods
We conducted a retrospective analysis of 84 patients with cervical radiculopathy who were treated from 1997 to 2002. Thirty six of these patients were treated with ACMF and forty eight patients with ACDF.
Results
In the group of ACMF, the postoperative visual analogue scale(VAS) score was 2.6±0.9(Mean±SD), and the postoperative Oswestry score was 27.9±18.8, while in the group of ACDF, the postoperative VAS score was 2.7±1.1 and the postoperative Oswestry score was 26.2±19.2. The difference in the success rate between these groups was not statistically significant. The average length of stay in hospital was 3.9 days in the case of ACMF and 10.7 days in the case of ACDF. There was no delayed bony instability in both groups.
Conclusion
Although the concern has been voiced about the possibility of recurrence and instability after ACMF, this method provides acceptable operative management for herniated cervical disc or cervical spondylosis causing cervical radiculopathy. ACMF can overcome the disadvantages associated with ACDF, such as the increased load on the adjacent segment due to fixa- tion, pain and infection resulting from bone harvesting, a relatively long stay in the hospital, and the necessity to wear prosthetics.
Keywords: Radiculopathy, Intervertebral disc displacement, Spondylosis, Anterior cervical foraminotomy


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