Long-term radiological results of anterior cervical foraminotomy

Objective. To evaluate the intervertebral disc height and mobility of the operated segment in patients with cervical compression monoradiculopathy of degenerative etiology after anterior cervical foraminotomy (ACF) in the late postoperative period.

Material and Methods. The study included 50 patients (44 ± 9 years, 28–72 years) after ACF with a long-term postoperative period. The height of the operated and adjacent intervertebral discs was measured by the interbody distance and by Farfan method on CT scans before and after surgery. The mobility of the operated and adjacent segments was measured by the interspinous distance on functional radiographs. The follow-up period ranged from 3 to 93 months (mean 22 months).

Results. The height of the adjacent superior, operated and adjacent inferior intervertebral discs before surgery was 4.6 ± 0.9 mm, 4.6 ± 0.9 mm and 5.1 ± 0.9 mm and after surgery – 4.4 ± 0.9 mm, 2.8 ± 1.0 mm and 4.8 ± 0.9 mm, respectively. The mobility of the operated segment at the ACF level was 3.7 ± 2.4 mm, and of the adjacent superior and inferior segments – 7.1 ± 3.8 mm and 6.8 ± 2.4 mm, respectively. The mobility of the operated segment of 3 mm or more was detected in 38 (76%) patients (convincing mobility), and less than 3 mm – in 12 (24%) patients (questionable mobility). A combination of preserved disc (intervertebral disc height > 0 according to the Farfan method) and convincing mobility of the operated segment (≥3 mm) was detected in 25 (50%) patients. In 4 (8%) patients, the disc was preserved, but the segmental mobility was questionable. Disc collapse (intervertebral disc height = 0 according to the Farfan method) with questionable mobility of the operated segment was detected in 8 (16%) patients. In the remaining 13 (26%) cases, disc collapse was accompanied by convincing mobility of the operated segment.

Conclusion. The intervertebral disc and/or mobility of the operated segment were preserved in 84% of cases after ACF.

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