Low Rate of Same- and Adjacent-Segment Disease After Cervical ForaminotomyThe authors of this study report on the results of 325 patients who had a single-level, one-sided cervical foraminotomy. This procedure is used to relieve pressure on nerves that are being compressed or pinched by the intervertebral foramina. The foramen is the opening in the vertebrae through which the nerves exit from the spinal cord.
The procedure is done from the back of the neck with a tiny incision. This is called a keyhole operation. The muscle is peeled away to reveal the bone underneath. A small hole is cut into the vertebra itself. The foramen can be seen through this hole. The bone or disk material that is pressing on the nerve can be removed.
The focus of this study was to see how often patients developed the same problem in the same vertebra or in the adjacent vertebra (above or below it). Patients studied were treated between 1972 and 1992. There was an average of seven years follow-up.
The records were searched for any patient who had new disease at a same or adjacent level. Results were graded as excellent for patients with no pain, no medications, and normal work/activity status.
A good result was described as mild pain, occasional use of antiinflammatory drugs, and normal work/activity level. Patients with fair results had moderate pain, frequent drug use, restricted activity, and limited work ability. The final category poor reflected severe pain, narcotic use, and disability.
Results of this study showed a 6.7 per cent incidence of adjacent-segment disease over a 10-year period of time. There was a five per cent incidence of same-segment disease. Good or excellent outcomes were reported by 96.4 per cent of the patients. Nine per cent of the patients developed symptoms again at a later time.
The authors conclude that posterior cervical foraminotomy has a low rate of same- and adjacent-segment disease. It is an effective treatment for nerve compression in the neck.
Michelle J. Clarke, MD, et al. Same-Segment and Adjacent-Segment Disease Following Posterior Cervical Foraminotomy. In Journal of Neurosurgery: Spine. Vol. 6. No. 1. Pp. 5-9.
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