Anterior cervical foraminotomy for unilateral radicular disease

Study Design. A clinical series of patients with unilateral radiculopathy t reated with the anterior cervical foraminotomy procedure. Objective. To establish procedural techniques and clinical and radiologic o utcomes for the anterior cervical foraminotomy procedure. Summary of Background Data. Cervical radiculopathy is typically caused by u nilateral disc herniation or unco-vertebral osteophytes that compress the v entral aspect of the nerve. Direct removal of a cervical lesion causing rad icular symptoms without concomitant fusion seems to be an ideal treatment i n selected patients. The indications for an anterior cervical neural forami notomy are limited to unilateral radicular symptoms at one or two levels, w ith minimal neck pain. Methods. Twenty-one patients were treated with the anterior cervical neural foraminotomy procedure during a 3-year period with follow-up from 6 to 36 months. There were 13 men and 8 women (age range, 27-58 years). Fourteen pa tients had symptomatic soft disc herniation, and 7 had uncovertebral osteop hytes confirmed by magnetic resonance imaging and/or myelogram and computed tomography. Sixteen patients had a single anterior cervical neural foramin otomy, and 5 had procedures at adjacent levels. Results. Nineteen patients (91%) had improved or resolved radicular symptom s, and 2 (9%) had persistent radicular symptoms necessitating further surge ry (one two-level anterior cervical neural discectomy and fusion and one po sterior foraminal decompression). Conclusions. Patients Treated with the anterior cervical neural foraminotom y procedure have equivalent or better outcomes than those who undergo curre nt cervical procedures. It appears to be a good alternative procedure for c arefully selected patients with unilateral cervical radiculopathy and avoid s a fusion of the disc space.