Abstract

Aim: Evaluation of the clinical outcomes for patients undergoing anterior foraminal decompression (AFD). Material and methods: 154 patients with cervical radiculopathy and radiculomyelopathy. There were 102 (66,2%) male and 52 (33,8%) female, mean age 51,7 (24-67). All the patients had lateral disk herniation with osteophytes. I group: 108 (70%) patients with radiculopathy (96 monoradicular syndrome, 12 biradicular). II group: 46 (30 %) patients. Radiculopathy was associated with moderate myelopathic syndrome. All patients underwent AFD (by Jho H.D., 1996) without instrumentation with uncus resection, sequestrectomy and with osteophytes resection. 142 (92,2%) patients underwent one-level decompression, 8 (5,2%) two-level unilateral decompression, 4 (2.6%) two-level bilateral decompression. Diagnostics included: neurological status, cervical radiographs (standard, 3/4 position and functional), MRI, electrophysiology. Pain syndrome was evaluated by visual analog scale (VAS), myelopathic syndrome by EMS index. Results: All patients were followed for a minimum of 12 month after AFD. Patients from I group had significant regress of radicular syndrome after surgery. Excellent results were at 92% (pain regress more than 80%), good at 8% of patients (pain regress 70-80%). Pain radicular syndrome regress at patients from II group has no significant differences from I group. Myelopathic syndrome regress was also estimated as good. EMS index preoperative showed 12,3+/-1,4 points; postoperatively 14,7 +/-1.9. Functional radiographs obtained at 3 months and 1 year after surgery indicated that none of the patients had evidence of delayed instability. Conclusion: AFD is an effective minimally invasive procedure. It appears to be a good alternative procedure to cervical decompression with fusion.