Posterior cervical foraminotomy for cervical radiculopathy: should cervical alignment be considered?

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Deformity Correction

Background:

• Posterior cervical foraminotomy (PCF) is often avoided with kyphotic or straight preoperative sagittal alignment.
• Understanding postoperative changes in cervical alignment after PCF is crucial.

Purpose of the Study:

• To determine interval changes in cervical segmental angles after PCF.
• To analyze factors influencing cervical sagittal re-alignment post-surgery.

Main Methods:

• 286 patients undergoing PCF had lateral radiographs taken preoperatively, 2 days, and 6 months postoperatively.
• Cervical sagittal alignment (C2-C7 angle) and visual analogue scale (VAS) for pain were assessed.
• Factors analyzed included disc herniation vs. stenosis, symptom duration, age, and VAS scores.

Main Results:

• Over two-thirds of patients showed short-term improvement in sagittal alignment.
• Improvements were maintained and became more prominent at 6 months (P<0.05).
• Better outcomes were associated with disc herniation (vs. stenosis), shorter symptom duration, and reduced VAS scores.

Conclusions:

• PCF is a viable surgical option for radiculopathy, particularly from softened discs, even with preoperative kyphotic alignment.
• The procedure demonstrates sustained positive effects on cervical sagittal alignment.