J Korean Orthop Assoc.  2021 Dec;56(6):512-518. 10.4055/jkoa.2021.56.6.512.

Comparison of the Morphometric Changes in the Cervical Foramen: Anterior Cervical Discectomy and Fusion versus Posterior Foraminotomy

• Chung SS
• Sun WS
• Chung JC
• Heo KS
• Kim HM

• KMID: 2523281
• DOI: http://doi.org/10.4055/jkoa.2021.56.6.512

Abstract

Purpose
This study compared the change in foraminal space on magnetic resonance imaging (MRI) and the clinical outcome after anterior cervical discectomy and fusion (ACDF) versus foraminotomy in cervical foraminal stenosis.
Materials and Methods
A retrospective case-control study was conducted from January 2018 to March 2019 on 186 patients who underwent ACDF and foraminotomy. One hundred and two cases were selected considering age, sex, and body mass index. MRI was performed before and on the 5^th day after surgery to compare the changes in the foraminal diameter between the ACDF group (group A-51) and foraminotomy group (group B-51).
Results
Between groups A and B, the average change in foraminal vertical diameter was 1.7 mm and 1.2 mm, respectively; group A was 0.5 mm larger difference (p=0.042). The average change in foraminal transverse diameter was 1.2 mm and 1.8mm, respectively; group B showed a 0.6 mm larger change (p=0.21). Both the neck disability index (NDI) and Japanese orthopaedic association (JOA) scores improved in both groups. Group A showed more improvement, but there was no significant difference (p=0.356, p=0.607, respectively).
Conclusion
Foraminotomy is a useful option for patients with foraminal stenosis of the cervical spine because it showed comparable clinical and morphological results to ACDF and could minimize motion segment loss and muscle and ligament damage.

Keyword

cervical foraminal stenosis; anterior cervical discectomy and fusion; foraminotomy