gms | German Medical Science

Objective: Minimal invasive dorsal foraminotomy for lateral cervical disc disease is an established surgical technique with preservation of the motion segment.

Methods: 71 patients (2006 to 2010) were operated on by a monosegmental minimal invasive dorsal foraminotomy due to lateral or intraforaminal cervical soft disc sequestration. Hard disc disease or median sequestration as also foraminal stenosis were treated via a ventral approach. Surgery was performed in case of neurological deficits or failed conservative treatment. A retrospective analysis was performed with a median follow up period of 31.6 months (range 13–68 months). Patients were evaluated with standard neurological examination, NDI, VAS arm/neck pain and lateral functional x-ray imaging of the cervical spine.

Results: 59% of the patients could be followed up (21/21 male/female patients, mean age 52 y, range 29–78 year). Preoperative motor and sensory dysfunction improved in 80% and remained unchanged in 20%. Preoperative pain (VAS) decreased from 7.6 to 2.2. 60% still complain of neck pain and receive physiotherapy, but only 18% need pain medication. Lateral fexion/extension radiographs showed no adjacent level degeneration or instability of the treated segment however a disc space subsidence (mean 0,3 mm) was noted.

Conclusions: In this series no evidence of adjacent level degeneration or instability due to facet joint violation could be established. However a large number of patients complain of persistent neck pain, which can be attributed to the degree of facet joint opening, but can be well treated by physiotherapy.