Transpedicular approaches to cervical uncovertebral osteophytes causing radiculopathy

Object. The anterolateral and posterior transpedicular foraminotomies were developed to enhance the treatment of cervical spondylotic radiculopathy se condary to uncovertebral osteophytes. These novel surgical approaches may b e advantageous because they allow direct decompression of the nerve root wh ile preserving normal movement and stability of the motion segment. The use of the pedicle to obtain access to compressive uncovertebral osteophytes, without causing damage to the motion segment, has not been previously repor ted. Methods. The authors present the early outcome data obtained in 27 patients who underwent an anterolateral or posterior foraminotomy. Eighty-eight per cent of patients who underwent anterolateral foraminotomy and 94% of those who underwent a posterior transpedicular procedure experienced complete or significant relief of brachialgia. Postoperatively none of the patients wer e symptomatically or neurologically worse. Conclusions. The transpedicular approach is an effective and potentially im proved method of treating symptomatic cervical uncovertebral osteophytes co mpared with techniques previously described.