Posterior Cervical Foraminotomy and Laminectomy

  • John E. O’TooleEmail author
  • Kurt M. Eichholz
  • Richard G. Fessler


Posterior decompressive procedures are fundamental tools in the surgical treatment of symptomatic cervical degenerative spine disease [1–4]. Even as anterior cervical procedures have gained prominence, posterior cervical laminoforaminotomy still provides symptomatic relief in 92–97% of patients with radiculopathy from foraminal stenosis or lateral herniated discs [3, 5]. Similarly, posterior cervical decompression for cervical stenosis achieves neurological improvement in 62.5–83% of myelopathic patients undergoing either laminectomy or laminoplasty [4, 6–8]. Moreover, these operations avoid the complications attendant to anterior approaches to the cervical spine, namely, esophageal injury, vascular injury, recurrent laryngeal nerve paralysis, dysphagia, and accelerated degeneration of adjacent motion segments after fusion [9–11].


Neck Disability Index Ligamentum Flavum Recurrent Laryngeal Nerve Paralysis Japanese Orthopedic Association Score Foraminal Stenosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Aldrich F. Posterolateral microdisectomy for cervical monoradiculopathy caused by posterolateral soft cervical disc sequestration. J Neurosurg. 1990 March;72(3):370–377.CrossRefPubMedGoogle Scholar
  2. 2.
    Crandall PH, Batzdorf U. Cervical spondylotic myelopathy. J Neurosurg. 1966 July;25(1):57–66.CrossRefPubMedGoogle Scholar
  3. 3.
    Henderson CM, Hennessy RG, Shuey HM, Jr., Shackelford EG. Posterior-lateral foraminotomy as an exclusive operative technique for cervical radiculopathy: a review of 846 consecutively operated cases. Neurosurgery. 1983 November;13(5):504–512.CrossRefPubMedGoogle Scholar
  4. 4.
    Ratliff JK, Cooper PR. Cervical laminoplasty: a critical review. J Neurosurg. 2003 April;98(3 Suppl):230–238.PubMedGoogle Scholar
  5. 5.
    Khoo LT, Perez-Cruet MJ, Laich DT, Fessler RG. Posterior cervical microendoscopic foraminotomy. In: Perez-Cruet MJ, Fessler RG, editors. Outpatient Spinal Surgery. St. Louis: Quality Medical Publishing, Inc.; 2006. pp. 71–93.Google Scholar
  6. 6.
    Kumar VG, Rea GL, Mervis LJ, McGregor JM. Cervical spondylotic myelopathy: functional and radiographic long-term outcome after laminectomy and posterior fusion. Neurosurgery. 1999 April;44(4):771–777; discussion 777–778.CrossRefPubMedGoogle Scholar
  7. 7.
    Wang MY, Green BA. Laminoplasty for the treatment of failed anterior cervical spine surgery. Neurosurg Focus. 2003 September 15;15(3):E7.CrossRefPubMedGoogle Scholar
  8. 8.
    Wang MY, Shah S, Green BA. Clinical outcomes following cervical laminoplasty for 204 patients with cervical spondylotic myelopathy. Surg Neurol. 2004 December;62(6):487–492; discussion 492–483.CrossRefPubMedGoogle Scholar
  9. 9.
    Fessler RG, Khoo LT. Minimally invasive cervical microendoscopic foraminotomy: an initial clinical experience. Neurosurgery. 2002 November;51(5 Suppl):S37–S45.PubMedGoogle Scholar
  10. 10.
    Hilibrand AS, Robbins M. Adjacent segment degeneration and adjacent segment disease: the consequences of spinal fusion? Spine J. 2004 November-December;4(6 Suppl):190S–194S.CrossRefPubMedGoogle Scholar
  11. 11.
    Ishihara H, Kanamori M, Kawaguchi Y, Nakamura H, Kimura T. Adjacent segment disease after anterior cervical interbody fusion. Spine J. 2004 November-December;4(6):624–628.CrossRefPubMedGoogle Scholar
  12. 12.
    Hosono N, Yonenobu K, Ono K. Neck and shoulder pain after laminoplasty. A noticeable complication. Spine. 1996 September 1;21(17):1969–1973.CrossRefPubMedGoogle Scholar
  13. 13.
    Siddiqui A, Yonemura KS. Posterior cervical mircoendoscopic diskectomy and laminoforaminotomy. In: Kim DH, Fessler RG, Regan JJ, editors. Endoscopic Spine Surgery and Instrumentation: Percutaneous Procedures. New York: Thieme; 2005. pp. 66–73.Google Scholar
  14. 14.
    Albert TJ, Vacarro A. Postlaminectomy kyphosis. Spine. 1998 December 15;23(24):2738–2745.CrossRefPubMedGoogle Scholar
  15. 15.
    Kaptain GJ, Simmons NE, Replogle RE, Pobereskin L. Incidence and outcome of kyphotic deformity following laminectomy for cervical spondylotic myelopathy. J Neurosurg. 2000 October;93(2 Suppl):199–204.PubMedGoogle Scholar
  16. 16.
    Perez-Cruet MJ, Samartzis D, Fessler RG. Microendoscopic cervical laminectomy. In: Perez-Cruet MJ, Khoo LT, Fessler RG, editors. An Anatomic Approach to Minimally Invasive Spine Surgery. St. Louis: Quality Medical Publishing, Inc.; 2006. pp. 16-11–16-17.Google Scholar
  17. 17.
    Yonenobu K, Okada K, Fuji T, Fujiwara K, Yamashita K, Ono K. Causes of neurologic deterioration following surgical treatment of cervical myelopathy. Spine. 1986 October;11(8):818–823.CrossRefPubMedGoogle Scholar
  18. 18.
    Khoo LT, Bresnahan L, Fessler RG. Cervical endoscopic foraminotomy. In: Fessler RG, Sekhar L, editors. Atlas of Neurosurgical Techniques: Spine and Peripheral Nerves. Vol. 1. New York: Thieme; 2006. pp. 785–792.Google Scholar
  19. 19.
    Burke TG, Caputy A. Microendoscopic posterior cervical foraminotomy: a cadaveric model and clinical application for cervical radiculopathy. J Neurosurg. 2000 July;93(1 Suppl):126–129.PubMedGoogle Scholar
  20. 20.
    Roh SW, Kim DH, Cardoso AC, Fessler RG. Endoscopic foraminotomy using MED system in cadaveric specimens. Spine. 2000 January 15;25(2):260–264.CrossRefPubMedGoogle Scholar
  21. 21.
    Adamson TE. Microendoscopic posterior cervical laminoforaminotomy for unilateral radiculopathy: results of a new technique in 100 cases. J Neurosurg. 2001 July;95(1 Suppl):51–57.CrossRefPubMedGoogle Scholar
  22. 22.
    Perez-Cruet MJ, Wang MY, Samartzis D. Microendoscopic cervical laminectomy and laminoplasty. In: Kim DH, Fessler RG, Regan JJ, editors. Endoscopic Spine Surgery and Instrumentation: Percutaneous Procedures. New York: Thieme; 2005. pp. 74–87.Google Scholar
  23. 23.
    Wang MY, Green BA, Coscarella E, Baskaya MK, Levi AD, Guest JD. Minimally invasive cervical expansile laminoplasty: an initial cadaveric study. Neurosurgery. 2003 February;52(2):370–373; discussion 373.CrossRefPubMedGoogle Scholar
  24. 24.
    Khoo LT, Fessler RG. Microendoscopic decompressive laminotomy for the treatment of lumbar stenosis. Neurosurgery. 2002 November;51(5 Suppl):S146–S154.PubMedGoogle Scholar
  25. 25.
    Yabuki S, Kikuchi S. Endoscopic partial laminectomy for cervical myelopathy. J Neurosurg Spine. 2005 February;2(2):170–174.CrossRefPubMedGoogle Scholar
  26. 26.
    Raynor RB, Pugh J, Shapiro I. Cervical facetectomy and its effect on spine strength. J Neurosurg. 1985 August;63(2):278–282.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • John E. O’Toole
    • 1
    Email author
  • Kurt M. Eichholz
    • 2
  • Richard G. Fessler
    • 3
  1. 1.Department of NeurosurgeryRush Medical College of Rush University Medical CenterChicagoUSA
  2. 2.Department of Neurological SurgeryVanderbilt University Medical CenterNashvilleUSA
  3. 3.Department of NeurosurgeryNorthwestern University; University of ChicagoChicagoUSA

Personalised recommendations