Skip to main content

Modified transcorporeal anterior cervical microforaminotomy for cervical radiculopathy: a technical note and early results

European Spine Journal volume 16, pages 1387–1393 (2007)Cite this article

Abstract

A prospective analysis of the first twenty patients operated for cervical radiculopathy by a new modification of transcorporeal anterior cervical foraminotomy technique. To evaluate early results of a functional disc surgery in which decompression for the cervical radiculopathy is done by drilling a hole in the upper vertebral body and most of the disc tissue is preserved. Earlier approaches to cervical disc surgery either advocated simple discectomy or discectomy with fusion, ultimately leading to loss of motion segment. Posterior foraminotomy does not address the more common anterior lesion. Twenty patients suffering from cervical radiculopathy not responding to conservative treatment were chosen for the new technique. Upper vertebral transcorporeal foraminotomy was performed with the modified technique in all the patients. All the patients experienced immediate/early relief of symptoms. No complications of vertebral artery injury, Horner’s syndrome or recurrent laryngeal nerve palsy were noted. Modified transcorporeal anterior cervical microforaminotomy is an effective treatment for cervical radiculopathy. It avoids unnecessary violation of the disc space and much of the bony stabilizers of the cervical spine. Short-term results of this technique are quite encouraging. Longer-term analysis can help in outlining the true benefits of this technique.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

References

  1. An HS, Takegami K, Kamada H et al (2004) Intradiscal administration of osteogenic protein-1 increases intervertebral disc height and proteoglycan content in the nucleus pulposus in normal adolescent rabbits. Spine 30:25–32

    Google Scholar 

  2. Benini A, Krayenbuhl H, Bruderl R (1982) Anterior cervical discectomy without fusion. Microsurgical technique. Acta Neurochir (Wien) 61(1–3):105–110

    Article  CAS  Google Scholar 

  3. Clements DH, O’Leary PF (1990) Anterior cervical discectomy and fusion. Spine 15:1023–1025

    PubMed  Article  CAS  Google Scholar 

  4. Cloward RB (1958) The anterior approach for removal of ruptured cervical discs. J Neurosurg 15:602

    PubMed  CAS  Google Scholar 

  5. DePalma AF, Rothman RH, Lewinnek GE et al (1972) Anterior interbody fusion for severe disc degeneration. Surg Gynecol Obstet 134:755–758

    PubMed  CAS  Google Scholar 

  6. Dmitriev AE, Cunningham BW, Hu N et al (2005) Adjacent level intradiscal pressure and segmental kinematics following a cervical total disc arthroplasty: An in vitro human cadaveric model. Spine 30:1165–1172

    PubMed  Article  Google Scholar 

  7. Ebersold MJ, Raynor RB, Bovis GK et al (1999) Cervical laminotomy, laminectomy, laminoplasty and foraminotomy. In: Benzel EC (ed) Spine surgery:techniques, complication avoidance and management. Churchill Livingstone, London, pp 251–253

  8. Fessler RG, Khoo LR (2002) Minimally invasive cervical microendoscopic foraminotomy: an initial clinical experience. Neurosurgery 51(Suppl 2):37–45

    Google Scholar 

  9. George B, Zerah M, Lot G et al (1993) Oblique transcorporeal approach to anteriorly located lesions in the cervical spinal canal. Acta Neurochir 121:187–190

    Article  CAS  Google Scholar 

  10. Hakuba A (1976) Trans-unco-discal approach. A combined anterior and lateral approach to cervical discs. J Neurosurg 45:284–291

    PubMed  CAS  Google Scholar 

  11. Hankinson HL, Wilson CB (1973) Use of the operating microscope in anterior cervical discectomy without fusion. J Neurosurg 43:452–456

    Google Scholar 

  12. Hilibrand AS, Carlson GD, Palumbo MA et al (1999) Radiculopathy and Myelopathy at segments adjacent to the site of a previous anterior cervical Arthrodesis. JBJS 81:519–528

    CAS  Google Scholar 

  13. Hilibrand AS, Yoo JU, Carlson GD et al (1997) The success of anterior cervical Arthrodesis adjacent to previous fusion. Spine 22:1574–1579

    PubMed  Article  CAS  Google Scholar 

  14. Jho HD (1996) Microsurgical anterior cervical foraminotomy. A new approach to cervical disc herniation. J Neurosurg 84:155–160

    CAS  Google Scholar 

  15. Jho HD, Kim WK, Kim MH (2002) Anterior microforaminotomy for treatment of cervical radiculopathy: part i—disc preserving “functional cervical disc surgery”. Neurosurgery 51(Suppl-2):46–53

    Google Scholar 

  16. Lesoin F, Biondi A, Jomin M (1987) Foraminal cervical herniatied disc treated by anterior discoforaminotomy. Neurosurg 21:334–338

    Article  CAS  Google Scholar 

  17. Lu DS, Shono Y, Oda I et al (1997) Effects of chondroitinase ABC and chymopapain on spinal motion segment biomechanics. An in vivo biomechanical, radiologic, and histologic canine study. Spine 22:1828–1834; discussion 34–35

    Google Scholar 

  18. Lundsford LD, Bissonette JD, Jannetta PJ et al (1973) Anterior surgery for cervical disc disease. Part 1: treatment of lateral cervical disc herniation in 253 cases. J Neurosurg 53:679–683

    Google Scholar 

  19. Martins AN (1976) Anterior cervical discectomy with and without interbody bone graft. J Neurosurg 44:290–295

    PubMed  CAS  Google Scholar 

  20. Pospiech J, Stolke D, Wilke HJ et al (1999) Intradiscal pressure recordings in the cervical spine. Neurosurgery 44:379–385

    PubMed  Article  CAS  Google Scholar 

  21. Prolo DJ, Oklund SA, Butcher M (1986) Towards uniformity in evaluating results of lumbar spine operations: A paradigm applied to posterior lumbar interbody fusions. Spine 11(6):601–606

    PubMed  Article  CAS  Google Scholar 

  22. Raynor RB, Pugh J, Shapiro I (1985) Cervical facetectomy and the effect on spine strength. J Neurosurg 63:278–282

    PubMed  CAS  Google Scholar 

  23. Sampath P, Bendebba M, Davis J et al (1999) Outcome in patients with cervical radiculopathy: prospective, multicenter study with independent clinical review. Spine 24:591–597

    PubMed  Article  CAS  Google Scholar 

  24. Saringer W, Nobauer I, Reddy M et al (2002) Microsurgical anterior cervical foraminotomy (Uncoforaminotomy) for unilateral radiculopathy: clinical results of a new technique. Acta Neurochir 144:685–694

    Article  CAS  Google Scholar 

  25. Savoluinen S, Usenius JP, Hernesniemi J (1994) Iliac crest versus artificial bone grafts in 250 cervical fusions. Acta Neurochir 129:54–57

    Article  Google Scholar 

  26. Schimandle JH, Boden SD (2003) Degenerative disorders of the cervical spine: cervical radiculopathy. In: Emery SE, Boden SD (eds) Surgery of the cervical spine, saunders. Elsevier Science, Philadelphia 94

  27. Smith EW, Robinson RA (1958) The treatment of certain cervical spine disorders by anterior removal of the intervertebral disc and interbody fusion. JBJS [A] 40:607

    Google Scholar 

  28. Snyder GM, Bernhardt AM (1989) Anterior cervical fractional interspace decompression for treatment of cervical radiculopathy. A review of the first 66 cases. Clin Orthop 246:92–99

    PubMed  Google Scholar 

  29. Urban JP, Holm S, Maroudas A et al (1977) Nutrition of the intervertebral disk. An in vivo study of solute transport. Clin Orthop Relat Res 101–114

  30. Urban JP, Holm S, Maroudas A et al (1982) Nutrition of the intervertebral disc: effect of fluid flow on solute transport. Clin Orthop Relat Res 296–302

  31. Verbiest H (1968) A lateral approach to cervical spine: technique and indications. J Neurosurg 28:191–203

    PubMed  CAS  Article  Google Scholar 

Download references

Acknowledgments

We are thankful to Sung Hui Myung, Song-Woo Shin, and Chi Gon Oh for their help in preparing the manuscript.

Author information

Affiliations

  1. Department of Neurosurgery, Wooridul Spine Hospital, 47-4, Chungdam-Dong, Gangnam-Gu, Seoul, 135-100, Korea

    Gun Choi, Sang-Ho Lee, Arun Bhanot, Yu Sik Chae, Byungjoo Jung & Seungcheol Lee

Authors
  1. Gun Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sang-Ho Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Arun Bhanot
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yu Sik Chae
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Byungjoo Jung
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Seungcheol Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gun Choi.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Choi, G., Lee, SH., Bhanot, A. et al. Modified transcorporeal anterior cervical microforaminotomy for cervical radiculopathy: a technical note and early results. Eur Spine J 16, 1387–1393 (2007). https://doi.org/10.1007/s00586-006-0286-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-006-0286-6

Keywords

  • Cervical radiculopathy
  • Transcorporeal
  • Foraminotomy