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KMID : 1148120170070020047
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Journal of Advanced Spine Surgery
2017 Volume.7 No. 2 p.47 ~ p.54
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Clinical and Radiologic Outcomes of Luschka’s Joint Preservation vs. Total Uncinatectomy in Anterior Cervical Microforaminotomy
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Woo Jong-Yun
Lim Jae-Hyeon
Jang Il-Tae
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Abstract
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Purpose: To evaluate the difference of clinical and radiologic outcomes between Luschka’s joint preservation vs. total uncinatectomy in anterior cervical microforaminotomy.
Materials and Methods: From Dec. 2006 to Feb. 2012, 37 patients suffered unilateral cervical radiculopathy due to cervical foraminal disc herniation or spondylotic cervical stenosis underwent anterior cervical microforaminotomy in our hospital. The mean age of patients was 52.9 (range 35 to 72). 27 were men and 10 were women. 19 patients received total uncinatectomy and the other 18 patients received partial uncinatectomy. There was no difference in statistical significance for demographic factors between two groups. Clinical outcomes have been evaluated based on preoperative and postoperative VAS scores for axial pain and radicular pain described on medical records and classified according to modified Odom’s criteria. Postoperative radiologic evaluation was performed through follow up CT, MRI and plain films. Through this serial studies, postoperative degenerative change was evaluated.
Results: Mean follow up period was 44.6 months (from 12 month to 86 months). 6 of 19 patients from total
uncinatectomy group suffered chronic postoperative axial neck pain lasting over 3 months after the surgery. In
contrast, only 2 of 18 patients in the partial uncinatectomy group complained chronic neck pain. One patient of the
partial uncinatectomy group underwent revision surgery due to incomplete decompression. The revision surgical
modality was ACDF. Surgical result was classified according to modified Odom’s criteria. But, there was no statistical
differences between outcomes of two groups. During the follow up period, degenerative change was observed in 10
of 19 patients in total uncinatectomy group and 7 of 18 patients in partial uncinatectomy group. But, there was no
statistical differences, either (by Kaplan-Meier).
Conclusions: Anterior cervical microforaminotomy for unilateral cervical radiculopathy showed favorable results regardless of pathologic lesions, such as disc herniation or stenosis. Total uncinatectomy group seems to cause postoperative chronic axial neck pain, but there was no statistical significance. Anterior cervical microforaminotomy causes early degenerative changes of involved segment. There was no difference in development of degenerative changes between total uncinatectomy group and partial uncinatectomy group
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KEYWORD
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Foraminal disc, Microsurgical cervical foraminotomy, Uncinatectomy
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