Intervertebral Foramen Width Is an Important Factor in Deciding Additional Uncinate Process Resection in ACDF-a...

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Surgery

Background:

• Anterior cervical discectomy and fusion (ACDF) is a standard treatment for cervical radiculopathy.
• The necessity of combining ACDF with uncinate process resection (UPR) remains debated for optimal patient outcomes.

Purpose of the Study:

• To compare the clinical outcomes of ACDF with UPR versus ACDF alone in treating cervical radiculopathy.
• To determine if UPR is necessary based on pre-operative intervertebral foramen dimensions.

Main Methods:

• Retrospective review of 55 patients undergoing ACDF with UPR and 126 patients undergoing ACDF alone.
• Measurement of intervertebral foramen width (wIVF) and height (hIVF) using oblique X-rays.
• Assessment of Japanese Orthopedic Association (JOA) and visual analog scale (VAS) scores, and C2-C7 Cobb angles pre- and post-operatively.

Main Results:

• ACDF with UPR showed no significant correlation between pre-operative foramen dimensions and clinical outcome improvement.
• In the ACDF alone group, pre-operative wIVF <3 mm was associated with poorer outcomes.
• Patients with wIVF >3 mm in the ACDF alone group had outcomes comparable to the ACDF+UPR group, with significant post-operative wIVF increase.

Conclusions:

• UPR should be considered for cervical radiculopathy when pre-operative intervertebral foramen width is less than 3 mm.
• UPR may not be necessary for ACDF when pre-operative intervertebral foramen width exceeds 3 mm, as ACDF alone yields similar results.