Long-term clinical and radiological outcomes of anterior uncoforaminotomy for unilateral single-level cervical radiculopathy: retrospective cohort study.
Spine J 2021;
21:915-923. [PMID:
33545373 DOI:
10.1016/j.spinee.2021.01.024]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 01/19/2021] [Accepted: 01/26/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT
Anterior cervical discectomy and fusion is a common procedure for degenerative cervical radiculopathy. In 1996, Dr. H.D. Jho reported an operative technique allowing nerve root decompression via anterior uncoforaminotomy whereas avoiding fusion.
PURPOSE
To assess long-term clinical and radiological outcomes of anterior uncoforaminotomy in patients with degenerative cervical spine pathology.
STUDY DESIGN
A single clinic, retrospective cohort study.
PATIENT SAMPLE
Adult patients who underwent anterior uncoforaminotomy from 2013 to 2018.
OUTCOME MEASURES
Clinical outcomes were assessed using VAS, NDI, SF-36 criteria. Radiological parameters included sagittal balance, disc height and White anPanjabi criterion.
MATERIALS AND METHODS
All patients underwent unilateral single-level anterior uncoforaminotomy, and long-term clinical and radiologic follow up was carried out. Clinical outcomes were assessed using VAS, NDI, SF-36 criteria. Radiological parameters evaluated included sagittal balance, disc height and White and Panjabi criteria (3.5 mm of translation, 11 degrees of kyphosis). The mean follow-up period was 33.3 ± 10.6 months (range 12-57 months).
RESULTS
All measures of clinical outcome improved. VAS (neck) and VAS (arm) decreased 3 [2; 4] and 5 [3; 5.2] points (median [interquartile range]), respectively (p<0.001); NDI improved from 0.38 [0.36; 0.4], to 0.29 [0.22; 0.34] (p<0.001). Two patients (6%) required additional surgery one year after operation. There were no complications in the perioperative period. Disc height decreased 0.8 mm [0.1; 2.1] (p<0.001). All patients retained stability of the cervical spine based on White and Panjabi criteria. Sagittal balance parameters did not change significantly.
CONCLUSION
Uncoforaminotomy is an effective and safe method to decompress a unilateral single-level nerve root in degenerative cervical radiculopathy whereas preserving anatomy and motion of the cervical spine.
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