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Same-segment and adjacent-segment disease following posterior cervical foraminotomy
Michelle J Clarke1, Robert D Ecker, William E Krauss
1Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
Journal of Neurosurgery. Spine
|January 20, 2007
Summary
Posterior cervical foraminotomy for radiculopathy shows low rates of adjacent- and same-segment disease. Long-term outcomes suggest this surgical approach is safe and effective for managing cervical radicular symptoms.
Area of Science:
- Neurosurgery
- Spine Surgery
- Orthopedics
Background:
- Cervical foraminotomy, a posterior approach, was developed in the 1940s for radicular symptoms.
- Long-term outcomes of this procedure have not been extensively studied.
Purpose of the Study:
- To evaluate the long-term incidence of symptomatic adjacent- and same-segment disease after posterior cervical foraminotomy.
Main Methods:
- Retrospective analysis of 303 patients undergoing single-level posterior cervical foraminotomy for radiculopathy (1972-1992).
- Median follow-up of 7.1 years.
- Kaplan-Meier survivorship analysis to predict disease natural history.
Main Results:
- Symptomatic adjacent-segment disease developed in 4.9% of patients (6.4/1000 person-years), with 2.9% requiring reoperation.
- Kaplan-Meier analysis indicated a stable annual adjacent-segment disease rate of 0.7% (10-year rate of 6.7%).
- Same-segment disease occurred in 3.3% of patients (3.9/1000 person-years), with 5- and 10-year rates of 3.2% and 5.0% respectively.
Conclusions:
- Posterior cervical foraminotomy is associated with a low incidence of adjacent- and same-segment disease.
- The findings suggest a favorable long-term outcome for this surgical technique.