Minimally invasive cervical foraminotomy and decompression of stenosis

Abstract

Many types of degenerative cervical spine disease can be treated with well-established posterior decompressive procedures [1-4]. Even as anterior cervical procedures have gained prominence, posterior cervical laminoforaminotomy still provides symptomatic relief in 92-97 % of patients with radiculopathy from foraminal stenosis or lateral herniated discs [3, 5]. Similarly, posterior cervical decompression for cervical stenosis achieves neurological improvement in 62.5-83 % of myelopathic patients undergoing either laminectomy or laminoplasty [4, 6-8]. Moreover, these operations avoid the complications attendant to anterior approaches to the cervical spine, namely, esophageal injury, vascular injury, recurrent laryngeal nerve paralysis, dysphagia, and accelerated degeneration of adjacent motion segments after fusion [9-11]. Anterior cervical decompression and fusion (ACDF) procedures have also been shown to cost 89 % more than posterior cervical foraminotomy (PCF), suggesting PCF may potentially be considered a more cost-effective as well as safer solution in select cases [12].