DECOMPRESSION VIA MICROSURGICAL ANTERIOR FORAMINOTOMY FOR CERVICAL SPONDYLOTIC MYELOPATHY - TECHNICAL NOTE

Over the past few years, a microsurgical anterior foraminotomy techniq ue has been developed by the author and used to achieve spinal cord de compression for the treatment of cervical spondylotic myelopathy. A 5 x 8-mm unilateral anterior foraminotomy is accomplished by resecting t he uncovertebral joint via an anterior approach. Through the foraminot omy hole, the posterior osteophytes at the spinal cord canal are remov ed diagonally up to the beginning of the contralateral nerve root. To treat multilevel disease, a tunnel is made among the foraminotomy hole s. This technique accomplishes widening of the spinal cord canal in th e transverse and longitudinal axes by direct resection of the compress ive lesions through the holes of unilateral anterior foraminotomies; h owever, it does not require bone fusion or postoperative immobilizatio n. Postoperatively patients remain in the hospital overnight, and do n ot need to wear cervical braces. This new surgical technique has shown excellent clinical outcomes with fast recovery and adequate anatomica l decompression in patients with cervical spondylotic myelopathy. The surgical technique is reported and illustrated by two of the author's cases.