Microendoscopic posterior cervical laminoforaminotomy for unilateral radiculopathy: results of a new technique in 100 cases

Object. In this report the author presents surgery-related outcomes after a pplication of a new technique. A posterior microendoscopic laminoforaminoto my was used for the surgical treatment of unilateral cervical radiculopathy secondary to intervertebral disc herniations and/or spondylotic foraminal stenosis. The results of this procedure are compared with those achieved us ing traditional laminoforaminotomy and anterior cervical discectomy with or without fusion. Methods. One hundred consecutive patients who experienced unilateral cervic al radicular syndromes, which were refractory to conservative therapy, and in whom imaging studies had confirmed lateral canal or foraminal compressio n, underwent surgical treatment. An endoscopy-assisted posterior laminofora minotomy was performed using a microendoscopic visualization system for rem oval of herniated disc and foraminal decompression while the patient was in the sitting position. Excellent or good results were obtained in 97 patients, who returned to the ir preoperative employment and baseline level of physical activity. One pat ient returned to work but was unable to perform at baseline level; two pati ents returned to prior sedentary work but continued to have some activity-r elated pain and paresthesias. Two patients report ed experiencing intermitt ent paresthesias or numbness, but this did not limit their activities. Ther e were two cases of dural punctures, one case of superficial wound infectio n, and no deaths. Conclusions. The microendoscopic posterior laminoforaminotomy is an effecti ve alternative for the treatment of unilateral cervical radiculopathy secon dary to lateral or foraminal disc herniations or spondylosis. In this group of patients, it is preferable because it does not require the sacrifice of a cervical motion segment, has a low incidence of complications, and is as sociated with a much quicker return to unrestricted full activity than that obtained with other techniques.