Posterior Laminoforaminotomy for Radiculopathy
Cervical spondylosis is a commonly encountered degenerative condition and represents one of the most frequently treated diagnoses in neurosurgery. Its prevalence has recently been demonstrated as 89.7% in patients with a mean age of 56.4. Additionally, these patients may have more severe symptoms from nerve root or spinal cord compression, resulting in radicular pain or myelopathy, possibly causing a neurological deficit. Posterior cervical laminoforaminotomy (PCLF) was first described by Spurling and Scoville in 1944 and represents a safe and effective surgical technique by which to treat cervical radiculopathy in patients who have failed conservative therapy. The aim of this chapter is to describe the indications, contraindications, techniques, and complications of PCLF while providing a review of the current literature regarding this approach.
KeywordsPosterior laminoforaminotomy Radiculopathy PCLF Cervical spondylosis Cervical radiculopathy Compression Microendoscopic foraminotomy MEF
- 1.Nouri A, Martin A, Tetreault L, Nater A, Kato S, Nakashima H, Nagoshi N, Reihani-Kermani H, Fehlings MG. MRI analysis of the combined prospectively collected AOSpine North America and International Data: the prevalence and spectrum of pathologies in a global cohort of patients with degenerative cervical myelopathy. Spine (Phila Pa 1976). 2017;42(14):1058–67.CrossRefGoogle Scholar
- 2.Hult L. The Munkfors investigation; a study of the frequency and causes of the stiff neck-brachialgia and lumbago-sciatica syndromes, as well as observations on certain signs and symptoms from the dorsal spine and the joints of the extremities in industrial and forest workers. Acta Orthop Scan Suppl. 1954;16:1–76.Google Scholar
- 3.Spurling RG, Scoville WB. Lateral rupture of the cervical intervertebral disks: a common cause of shoulder and arm pain. Surg Gynecol Obstet. 1944;78:350–8.Google Scholar
- 10.Church EW, Halpern CH, Faught RW, Balmuri U, Attiah MA, Hayden S, Kerr M, Maloney-Wilensky E, Bynum J, Dante SJ, Welch WC, Simeone FA. Cervical laminoforaminotomy for radiculopathy: symptomatic functional outcomes in a large cohort with long-term follow-up. Surg Neurol Int. 2014;5(Suppl 15):S536–43.CrossRefGoogle Scholar
- 16.Bydon M, Mathios D, Macki M, de la Garza-Ramos R, Sciubba DM, Witham TF, Wolinsky JP, Gokasalan ZL, Bydon A. Long-term patient outcomes after posterior cervical foraminotomy: an analysis of 151 cases. J Neurosurg Spine. 2014;21(5):727–31.Google Scholar