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Surgical Result of Posterior Foraminotomy for Cervical Spondylotic Foraminal Stenosis
Sang-Woo Park, M.D., Sung-Woo Roh, M.D., Sang-Ryong Jeon, M.D., Seung-Chul Rhim, M.D.
Department of Neurosurgery, ASAN Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
경추 퇴행성 추간공 협착증 환자에서 후방추간공확장술의 수술 결과
박상우,노성우,전상룡,임승철
울산대학교 의과대학 서울아산병원 신경외과학교실
Abstract
Objective: Recently, anterior foraminotomy combined with or without interbody fusion has been more frequently performed for the cervical spondylotic foraminal stenosis than posterior decompression. But posterior key hole foraminotomy has been another?surgical option for nerve root compression secondary to cervical spodylotic foraminal stenosis. We analyzed surgical result to ververify the effectiveness, feasibility and safety of posterior foraminotomy.
Methods: 11 consecutive cases with cervical spondylotic foraminal stenosis who underwent posterior foraminotomy were retrospectively reviewed with medical records, image study including preoprerative and postoperative computed tomography. Patient's demographic data, surgical technique, length of decompressed nerve root with relation to the amount of medial facetectomy, postoperative instability, preoprerative and postoperative neck pain were analyzed. Functional outcome was also analyzed with VAS visual analogue scale) and Whitecloud clinical outcome scale by telephone interview.
Result: Most presenting symptoms were chronic radiculopathy combined with or without neck pain. Two level foraminotomy was performed in 8 cases, one level in 3 cases. The mean preoperative VAS was 8±0.78. The mean postoperative VAS was decreased to 2.27±1.79. The mean lenghth of the decompressed nerve root was 8± 1.77mm. The mean percent of facetectomy was 43.9±10.7%. The clinical outcome was exellent or good in 9 cases(81.8%), and fair in 2 cases(18.2%). There was no definite postoperative instability or intolerable neck pain and also there were no operative complications.
Conclusion: Posterior cervical foraminotomy seems to be safe and effective surgical option for the nerve root compression secondary to cervical spondylotic foraminal stenosis. Authors conclude that accurate diagnosis of cervical foraminal stenosis, identification of symptomatic nerve root and adequate decompression of neural structures may optimize patient's outcomes without postoperative complications or postoperative instability.
Keywords: Posterior foraminotomy.Cervical foraminal stenosis


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