Endoscopic Posterior Cervical Foraminotomy as a Treatment for Osseous Foraminal Stenosis

Abstract

Background: Posterior cervical foraminotomy is a valuable treatment option for cervical radiculopathy. Here the authors present their technique and results in the treatment of a series of patients suffering from osseous foraminal stenosis.

Methods: Forty-three patients suffering from cervical osseous foraminal stenosis were operated on via a posterior approach with the EasyGO endoscopic system. Decompression was performed in 1 segment in 31 patients, in 2 segments in 11 patients, and in 3 segments in 1 patient. Bilateral decompression was performed in 4 cases. Twenty-four (55.8%) patients had been subjected to previous spine surgery. All procedures were video recorded and afterwards retrospectively analyzed. In addition, particular reference was given to previous cervical spine surgery, postoperative outcome, reoperation rate, and complications.

Results: The endoscopic system was easy to handle intraoperatively in all procedures. No emergency stopping was required. Forty-one patients reported improved and/or even no remaining pain postoperatively (95%). Thirty-five patients (81.4%) regained full motor strength. Clinical success rate with respect to Odom's criteria reached 39 patients (90.7%). One reoperation was needed due to postoperative hematoma (2.3%). One patient suffered from transient worsening of his preoperative paresis (2.3%). Neither dural tear nor nerve root injury was observed. Reoperation rate due to degenerative changes was 18.6% (8 of 43 patients).

Conclusions: This retrospective analysis shows that posterior endoscopic decompression is a successful option in the treatment of osseous cervical foraminal stenosis.

Keywords: Cervical spine; EasyGO system; Endoscopy; Minimally invasive technique; Osseous foraminal stenosis; Posterior cervical foraminotomy.