Same-segment and adjacent-segment disease following posterior cervical foraminotomy

Michelle J. Clarke, Robert D. Ecker, William E. Krauss, Robyn L. McClelland, Mark B. Dekutoski

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67 Scopus citations

Abstract

Object. The cervical foraminotomy was pioneered in the 1940s to address radicular symptoms via a posterior approach, but the long-term outcome has not been adequately studied. Methods. The authors retrospectively analyzed data obtained from 303 patients (188 male and 115 female, mean age 49.2 years) who had consecutively undergone a single-level posterior foraminotomy for cervical radiculopathy between 1972 and 1992. The median follow-up duration was 7.1 years. The major end point studied was the development of symptomatic adjacent- or same-segment disease. Incidence rates per 1000 person-years were calculated, and the natural history of the disease was predicted using Kaplan-Meier survivorship analysis. In 15 (4.9%) of 303 patients, symptomatic adjacent-segment disease developed, yielding a rate of 6.4/1000 personyears at risk. This included nine (2.9%) of 303 patients requiring reoperation, yielding a rate of 3.8/1000 person-years. Kaplan-Meier survivorship analysis suggested a relatively stable annual 0.7% rate for developing adjacent-segment disease, with a 10-year rate of 6.7%. Ten patients developed same-segment disease, yielding a risk rate of 3.9/1000 person-years. Kaplan-Meier survivorship analysis demonstrated a 5- and 10-year risk rate of developing same-segment disease of 3.2 and 5.0%, respectively. Conclusions. Although additional study is needed, analysis of the present data suggests that posterior foraminotomy is associated with a low rate of same- and adjacent-segment disease.

Original languageEnglish (US)
Pages (from-to)5-9
Number of pages5
JournalJournal of Neurosurgery: Spine
Volume6
Issue number1
DOIs
StatePublished - Jan 2007

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Keywords

  • Adjacent-segment disease
  • Cervical spine
  • Foraminotomy
  • Intervertebral disc

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology

Cite this

Clarke, M. J., Ecker, R. D., Krauss, W. E., McClelland, R. L., & Dekutoski, M. B. (2007). Same-segment and adjacent-segment disease following posterior cervical foraminotomy. Journal of Neurosurgery: Spine, 6(1), 5-9. https://doi.org/10.3171/spi.2007.6.1.2