Comparison of biomechanical response to surgical procedures used for cervical radiculopathy: Posterior keyhole foraminotomy versus anterior foraminotomy and discectomy versus anterior discectomy with fusion

The objective of this study was to compare the change in flexibility of C5- C6 caused by three procedures using a three-dimensional nonlinear finite el ement model: posterior foraminotomy (keyhole procedure), anterior foraminot omy with discectomy, and anterior discectomy with fusion. The keyhole proce dure produced a minor increase in motion. The anterior foraminotomy and dis cectomy produced one to mio times greater motion. Anterior discectomy with fusion produced 50% to 100% reduction in motion. The posterior keyhole fora minotomy has a much lesser effect on the stability of the cervical spine se gment than does an anterior procedure, and fusion is a requisite part of th e anterior decompression procedure.