Long-Term Outcomes After Microscopic Anterior Cervical Foraminotomy with a Minimum 10-Year Follow-Up

Abstract

Microscopic anterior cervical foraminotomy (MACF) is a surgical technique for unilateral cervical radiculopathy that preserves segmental motion and avoids adjacent segmental degeneration, but little is known of its long-term outcomes. A retrospective minimum 10-year follow-up study was conducted on patients treated by 1 surgeon. Clinical outcomes were assessed using a visual analog scale of neck and arm pain, Neck Disability Index, and Odom criteria. Surgical outcomes were assessed using additional procedure rates. Radiologic outcomes were estimated by measuring disc heights, segmental angles, and range of motion at the surgical level and adjacent segments, and so on. Of the 94 patients who underwent MACF between January 2000 and December 2004 by 1 surgeon, 69 were enrolled in this study. Median follow-up period was 11.9 years (range, 10.0-14.5 years). Visual analog scales for neck or arm pain and Neck Disability Index improved significantly during follow-up period (P < 0.001). Also, according to the Odom criteria, an excellent or good outcome was achieved in 62 patients (89.9%) at final follow-up. An additional procedure was performed in 10 patients (14.5%) for symptom recurrence during the follow-up period. The only risk factor found to be related to the need for an additional procedure was a small preoperative range of motion at the surgical level (P= 0.018). Although mean disc height at the surgical level decreased significantly (from 6.23 ± 1.10 to 5.17 ± 1.12 mm; P= 0.004), adjacent discs were not significantly affected. Although some radiologic results have shortcomings, the results of this study suggest that MACF has favorable long-term outcomes.