Minimum-Invasive Anterior Foraminotomy in Suirgery of Degenerative Changes in Cervical Spine

V.V. Stepanenko, Yu.A. Shulev, K.S. Gordienko, M.N. Yusupov, Yu.M. Bashkina

City Hospital N2, Saint Petersburg, Russia
Medical Academy of Postgraduate Education, Saint Petersburg, Russia

 

The study goal has been comparative estimation of clinical results in cases, subjected to anterior cervical decompression with an inter-body block and foraminal decompression.

Material and Methods. There were 162 cases with spondylogenic cervical radiculo- and radiculomyelopathy, operated in 1999-2009. Their age varied from 32 up to 68 years. There were 108 males (66.7%) and 54 females (33.3%). The cases were divided into the following groups, depending on a type of operation: group I anterior cervical decompression with an inter-body block (61 cases; 37.7%); group II anterior cervical decompression with an inter-body block and foraminal decompression (50 cases; 30.9%): group III foraminal decompression (51 cases; 31.4%).

Results. A minimum follow-up period was 1 year. Pain syndrome was estimated on the basis of the Visual-Analog Scale. Cases of group I were characterized by slower regression of pain in a neck and hand in comparison with patients of two other groups. One could watch good regression of pain in a hand in cases of group II; however it was slower in a neck. Pre- and postoperative EMS in anterior cervical decompression with an inter-body block were 10.8 and 14.8, respectively. The same indices in foraminal decompression were 11.2 and 14.7, respectively. There were no cases with instability a year after operation, as well as no compression relapses at operated levels. Long-tern neurological outcomes in anterior decompression were comparable with the results, watched in anterior cervical decompression with an inter-body block and reported by other authors.

Conclusion. Foraminal decompression is an effective and little-invasive method of surgical treatment of cases with cervical spondylogenic radiculopathy and radiculomyelopathy. Thorough selection of cases and precision microsurgery are a key to successful surgical treatment.