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KMID : 0361620210560060512
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Journal of the Korean Orthopaedic Association
2021 Volume.56 No. 6 p.512 ~ p.518
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Comparison of the Morphometric Changes in the Cervical Foramen: Anterior Cervical Discectomy and Fusion versus Posterior Foraminotomy
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Chung Sung-Soo
Sun Woo-Sung
Chung Jong-Chul
Heo Ki-Sung
Kim Hyun-Min
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Abstract
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Purpose: This study compared the change in foraminal space on magnetic resonance imaging (MRI) and the clinical outcome after anterior cervical discectomy and fusion (ACDF) versus foraminotomy in cervical foraminal stenosis.
Materials and Methods: A retrospective case-control study was conducted from January 2018 to March 2019 on 186 patients who underwent ACDF and foraminotomy. One hundred and two cases were selected considering age, sex, and body mass index. MRI was performed before and on the 5th day after surgery to compare the changes in the foraminal diameter between the ACDF group (group A-51) and foraminotomy group (group B-51).
Results: Between groups A and B, the average change in foraminal vertical diameter was 1.7 mm and 1.2 mm, respectively; group A was 0.5 mm larger difference (p=0.042). The average change in foraminal transverse diameter was 1.2 mm and 1.8mm, respectively; group B showed a 0.6 mm larger change (p=0.21). Both the neck disability index (NDI) and Japanese orthopaedic association (JOA) scores improved in both groups. Group A showed more improvement, but there was no significant difference (p=0.356, p=0.607, respectively).
Conclusion: Foraminotomy is a useful option for patients with foraminal stenosis of the cervical spine because it showed comparable clinical and morphological results to ACDF and could minimize motion segment loss and muscle and ligament damage.
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KEYWORD
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cervical foraminal stenosis, anterior cervical discectomy and fusion, foraminotomy
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