Long-term outcomes following anterior foraminotomy for one- or two-level cervical radiculopathy

Anterior foraminotomy (AF) is a surgical treatment for unilateral cervical radiculopathy that avoids fusion-related complications, but its long-term outcome has yet to be investigated. To clarify the efficacy of AF, the author retrospectively collected long-term data regarding the results of this technique.

At discharge, 98 % of patients reported improvement, although 20 % temporarily experienced some residual symptoms. There were no other major postoperative complications. At final follow-up (FU, mean of 8.8 years), an excellent or good outcome was achieved in 39 patients (89 %). There was no index level reoperation required, but two additional operations for symptomatic adjacent-segment degeneration were needed (4.5 %). Six patients suffered from shoulder pain on the same side after surgery (mean onset: 3.6 years). At final FU, significant degeneration at the operated level was demonstrated on plain radiographs, resulting in a decreased range of motion. However, loss of lordosis of the segment was minimal. Radiographically, adjacent segment degeneration was noted in only 6 and 11 % at the cranial and caudal segments, respectively.

In this retrospective study, patients who underwent AF for one- or two- level cervical radiculopathy showed a good long-term outcome with minimal adjacent segment degeneration. However, more data should be collected to clarify possible associations with these findings, such as delayed shoulder problems and aggravation of degeneration at the operated level.