Posterior Facetectomy with Fusion Using a Pedicle Screw for Parallel-shaped Cervical Foraminal Stenosis

Area of Science:

• Neurosurgery
• Spinal Surgery
• Orthopedic Surgery

Background:

• Severe cervical foraminal stenosis can cause significant arm and neck pain.
• Parallel-shaped stenosis presents unique surgical challenges.
• Posterior fusion techniques are evolving for cervical spine conditions.

Purpose of the Study:

• To evaluate the efficacy and safety of posterior facetectomy with fusion using pedicle screws (PF using FPS) for parallel-shaped severe cervical foraminal stenosis.
• To assess clinical and radiological outcomes after this surgical procedure.

Main Methods:

• Eight patients with 1- or 2-level parallel-shaped cervical foraminal stenosis underwent PF using FPS.
• Clinical outcomes (neck/arm pain, Neck Disability Index) and radiological parameters (Cobb's angle, segmental angle) were assessed preoperatively and at 12-month follow-up.
• Neurovascular complications, specifically screw breech, were monitored.

Main Results:

• Significant reductions in neck and arm pain (VAS scores decreased from 4.9 and 9.0 to 0.4, respectively).
• Improved cervical sagittal alignment (Cobb's angle increased from 11.1° to 17.0°).
• No neurovascular injuries were reported, indicating a safe procedure.

Conclusions:

• Posterior facetectomy with fusion using pedicle screws is a viable and safe treatment option for parallel-shaped severe cervical foraminal stenosis.
• The technique offers significant pain relief and improves cervical alignment.
• Further studies with larger cohorts are warranted to confirm these findings.