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Risk factors for outcome and complications of dorsal foraminotomy in cervical disc herniation

Andreas Jödicke1, Dorothea Daentzer, Stefanie Kästner

  • 1Department of Neurosurgery, University Medical Centre, Justus-Liebig University, Giessen, Germany.

Surgical Neurology
|August 6, 2003
PubMed

Insights

Dorsal foraminotomy for lateral cervical disc herniation can lead to surgical failure due to associated spondylosis or medial disc protrusion. Preoperative radicular pain duration is a key risk factor for poor outcomes.

Area of Science:

  • Neurosurgery
  • Spinal Surgery
  • Orthopedic Surgery

Background:

  • Dorsal foraminotomy is a common surgical approach for lateral cervical disc herniation.
  • Evaluating factors influencing complications and outcomes is crucial for this procedure.

Purpose of the Study:

  • To identify factors associated with surgical complications and clinical outcomes in dorsal foraminotomy for cervical disc herniation.

Main Methods:

  • A retrospective cohort study analyzed 39 patients undergoing surgery for cervical disc herniation between 1997 and 1999.
  • Preoperative imaging, surgical reports, and clinical evaluations (motor function, neck pain, radicular pain) were assessed.
  • Outcomes were graded using modified Odom's criteria at 6 weeks and 1 year postoperatively.

Main Results:

  • 18% of patients experienced neck irritation post-surgery; no new neurological deficits occurred.
  • Patients with preoperative paresis improved, but two cases of early relapse of medial disc prolapse were noted.
  • Associated spondylosis and residual mediolateral disc protrusion were linked to surgical failure; longer preoperative radicular pain duration predicted unfavorable outcomes.

Conclusions:

  • Associated spondylosis and medial disc protrusion increase the risk of surgical failure and complications in dorsal foraminotomy for lateral cervical disc herniation.
  • Enlarging bony decompression to reduce radicular failure may increase local failure risk.
  • Dorsolateral foraminotomy is effective and safe for carefully selected patients with lateral cervical free disc fragments.
Abstract

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