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Minimally Invasive versus Open Approach for Cervical Laminoforaminotomy

Published online by Cambridge University Press:  02 December 2014

Mark J. Winder  and
Kenneth C. Thomas
Mark J. Winder*
Affiliation:
Department of Neurosurgery, St. Vincent's Hospital, Sydney, Australia Department of Neurosurgery, Foothills Hospital, University of Calgary, Calgary, Alberta, Canada
Kenneth C. Thomas
Affiliation:
Department of Orthopedic Surgery, Foothills Hospital, University of Calgary, Calgary, Alberta, Canada
*
Level 7, St Vincent's Clinic, 430 Victoria St, Darlinghurst, NSW, Australia
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Abstract

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Background:

Minimally invasive posterior cervical foraminotomy for radicular symptoms has become more prevalent. The reported experience with microscopic tubular assisted posterior cervical laminoforaminotomy (MTPF) for the treatment of radicular pain is lacking. Tubular assisted techniques have been considered to offer significant benefit, over open procedures, in terms of minimizing tissue damage, operative time, blood loss, analgesic requirements and length of hospital stay. We hypothesized that MTPF reduces post-operative analgesic requirements and length of hospital stay over the traditional open laminoforaminotomy, with no difference in complication rates and, secondly, that MTPF is comparable to endoscopic posterior foraminotomy (EPF).

Methods:

We conducted a retrospective review of 107 patients who underwent posterior cervical laminoforaminotomy for radicular pain between 1999 and 2009. Patient demographics, intra-operative parameters, length of hospitalization, post-operative analgesic use, complications and short-term neurological outcome were compared between groups.

Results:

Between 1999 and 2009, a total of 107 patients were identified to have undergone a cervical foraminotomy. An open approach was used in 65 patients, while 42 underwent MTPF. Operative time and complications were comparable between groups. Significant differences favoring MTPF were observed in operative blood loss, post-operative analgesic use and length of hospital stay (p<0.001). All results were comparable to previous reports utilizing EPF.

Conclusions:

MTPF for the treatment of cervical radiculopathy significantly reduces blood loss, post-operative analgesic use and length of hospital stay compared to the standard open approach. Operative time and complication rates were comparable between both techniques, whilst MTPF offered similar results compared to EPF.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 38 , Issue 2 , March 2011 , pp. 262 - 267
Copyright
Copyright © The Canadian Journal of Neurological 2011

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