Research Article
BibTex RIS Cite

Anterior Cervical Discectomy and Fusion vs Posterior Key-Hole Foraminotomy in Single Level Cervical Discopathy

Year 2025, Volume: 12 Issue: 2, 174 - 178, 28.08.2025
https://doi.org/10.47572/muskutd.1642620

Abstract

Anterior cervical microdiscectomy and fusion (ACDF) and posterior cervical foraminotomy (PCF) are frequently applied surgical approaches in cervical radiculopathies. It is planned to compare and discuss the clinical results, complications, amount of bleeding, recurrence and reoperation rates, and instability development between these two methods and examine the superiority of the techniques in this study. Patient archives were scanned and clinical and radiological documents were examined for this retrospective study. Short-term (postoperative first 24 hours) and long-term (1-6 months) changes in preoperative complaints, preoperative and postoperative functional cervical spine radiographs and cervical MRI images, presence of complications, amount of bleeding, recurrence and reoperation status were recorded. Trauma patients, patients with instability and malignancy-related pathologies, patients with multilevel surgical intervention or previous cervical spine surgery anamnesis, patients under the age of 18, and patients whose data were not available were excluded from the study. No statistically significant difference was found between the amount of bleeding, pain in the first 24 hours postoperatively, pain in the 1st month, pain in the 6th month, development of complications, recurrence and reoperation rates, and development of instability. It was observed that the surgical time of posterior foraminotomy was shorter and was statistically significant. It was observed that neither surgical technique had any obvious superiority over the other in the 6-month postoperative period. Different results can be achieved with larger sample size and longer term follow-up.

References

  • Smith GW, Robinson RA. The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion. J Bone Joint Surg Am. 1958;40-A(3):607-24.
  • Spurling R, Scoville WB. Lateral rupture of the cervical intervertebral discs: a common cause of shoulder and arm pain. Surg Gynae Obst.1994;78: 350-8.
  • Frykholm R. Cervical nevre root compression resulting from disk degeneration and root sleeve fibrosis. Acta Chir Scand. 1951;160:1-149.
  • Korinth MC, Kruger A, Oertel MF, et al. Posterior foraminotomy or anterior discectomy with polymethylmethacrylate interbody stabilization for cervical soft disc disease: results in 292 patients with monoradiculopathy. Spine. 2006;31:1207–14.
  • Lin, G.-X, Rui, G, Sharma, S, et al. Does the neckpain, function, or range of motion differ after anterior cervical fusion, cervical disc replacement, and posterior cervical foraminotomy? World Neurosurg. 2019; 129: e485–93.
  • Mansfield, HE, Canar, WJ, Gerard, CS, et al. Single-level anterior cervical discectomy and fusion versus minimally invasive posterior cervical foraminotomy for patients with cervical radiculopathy: a costanalysis. Neurosurg. 2014;37(5):E9.
  • Ruetten S, Komp M, Merk H, et al. Full-endoscopic cervical posterior foraminotomy for the operation of lateral disc herniations using 5.9-mm endoscopes: a prospective, randomized, controlled study. Spine. 1976;2008;33(9):940-8.
  • Ji-jun, H, Hui-hui S, Zeng-wu S, et al. Posterior full-endoscopic cervical discectomy in cervical radiculopathy: a prospective cohort study. Clin. Neurol. Neurosurg. 2020; 195:105948.
  • Padhye K, Shultz P, Alcala C, et al. Surgical treatment of single level cervical radiculopathy: a comparison of anterior cervical decompression and fusion (ACDF) versus cervical disk arthroplasty (CDA) versus posterior cervical foraminotomy (PCF). Clin Spine Surg Spine. 2022; 35: 149–54.
  • Herkowitz HN, Kurz LT, Overholt DP. Surgical management of cervical soft disc herniation: a comparison between the anterior and posterior approach. Spine. 1990;15(10):1026–30.
  • Wirth FP, Dowd GC, Sanders HF, Wirth C. Cervical discectomy. A prospective analysis of three operative techniques. Surg Neurol. 2000;53(4):340–6.
  • Fang H, Cui M, Zhao K, et al. Minimally invasive posterior cervical foraminotomy versus anterior cervical fusion and arthroplasty: Systematic review and updated meta-analysis. Brain and Spine.2024;4:102852.
  • Lin GX, Rui G, Sharma S, et al. Does the neck pain, function, or range of motion differ after anterior cervical fusion, cervical discreplacement, and posterior cervical foraminotomy? World Neurosurg. 2019;129: e485–93.
  • Padhye K, Shultz P, Alcala C, et al. Surgical treatment of single level cervical radiculopathy. Clinical Spine Surgery. 2022;35(4):149–54.
  • Santangelo G, Wathen C, Macaluso D, et al. Comparison of Single-Level Posterior Cervical Foraminotomy to Anterior Cervical Discectomy and Fusion for Radiculopathy. Int J Spine Surg. 2023;17(3):418-25.
  • Wang TY, Lubelski D, Abdullah KG,et al. Rates of anterior cervical discectomy and fusion after initial posterior cervical foraminotomy. Spine J. 2015;15(5):971–6.
  • Ruetten S, Komp M, Merk H, et al. Full-endoscopic cervical posterior foraminotomy for the operation of lateral disc herniations using 5.9-mm endoscopes: a prospective, randomized, controlled study. Spine. 2008;33(9):940-8.

Tek Seviye Servikal Disk Hernilerinde Anterior Servikal Diskektomi ve Füzyon ile Posterior Key-Hole Foraminotominin Karşılaştırılması

Year 2025, Volume: 12 Issue: 2, 174 - 178, 28.08.2025
https://doi.org/10.47572/muskutd.1642620

Abstract

Servikal radikülopatilerde anterior servikal mikrodiskektomi ve füzyon (ACDF) ve posterior servikal foraminotomi (PCF) sık uygulanan cerrahi yaklaşımlardır. Bu çalışmada bu iki yöntem arasındaki klinik sonuçların, komplikasyonların, kanama miktarının, nüks ve reoperasyon oranlarının ve instabilite gelişiminin karşılaştırılarak tekniklerin birbirine üstünlüklerinin incelenmesi planlanmıştır. Retrospektif olarak planlanan çalışma için otomasyon sisteminden hasta arşivleri taranarak klinik ve radyolojik dökümanları incelendi. Ameliyat öncesi var olan şikayetlerin ameliyat sonrası kısa (postop ilk 24 saat) ve uzun dönemde değişimi (1-6 ay), preoperatif ve postoperatif fonksiyonel servikal vertebra grafileri ve servikal MR görüntüleri, komplikasyon varlığı, kanama miktarı, nüks ve reoperasyon durumu kayıt edildi. Travma hastaları, instabilite varlığı ve maligniteye bağlı patolojileri olan hastalar, multiseviye cerrahi girişim bulunan veya daha önce servikal omurga cerrahisi geçiren hastalar, 18 yaş altındaki hastalar ve verilerine ulaşılamayan hastalar çalışma dışında bırakıldı. Kanama miktarı, postoperatif ilk 24 saatte ağrı, 1. ayda ağrı, 6. ayda ağrı, komplikasyon gelişimi, nüks ve reoperasyon oranları ve instabilite gelişimi arasında istatistiksel olarak anlamlı farklılık saptanmamıştır. Posterior foraminotominin cerrahi süresinin daha kısa olduğu ve istatistiksel olarak anlamlı olduğu görülmüştür. Her iki cerrahi tekniğin ameliyat sonrası 6 aylık süre içinde birbirine bariz üstünlüğü bulunmadığı izlenmiştir. Daha büyük örneklem büyüklüğü ve daha uzun dönem takip ile farklı sonuçlara ulaşılabilir.

References

  • Smith GW, Robinson RA. The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion. J Bone Joint Surg Am. 1958;40-A(3):607-24.
  • Spurling R, Scoville WB. Lateral rupture of the cervical intervertebral discs: a common cause of shoulder and arm pain. Surg Gynae Obst.1994;78: 350-8.
  • Frykholm R. Cervical nevre root compression resulting from disk degeneration and root sleeve fibrosis. Acta Chir Scand. 1951;160:1-149.
  • Korinth MC, Kruger A, Oertel MF, et al. Posterior foraminotomy or anterior discectomy with polymethylmethacrylate interbody stabilization for cervical soft disc disease: results in 292 patients with monoradiculopathy. Spine. 2006;31:1207–14.
  • Lin, G.-X, Rui, G, Sharma, S, et al. Does the neckpain, function, or range of motion differ after anterior cervical fusion, cervical disc replacement, and posterior cervical foraminotomy? World Neurosurg. 2019; 129: e485–93.
  • Mansfield, HE, Canar, WJ, Gerard, CS, et al. Single-level anterior cervical discectomy and fusion versus minimally invasive posterior cervical foraminotomy for patients with cervical radiculopathy: a costanalysis. Neurosurg. 2014;37(5):E9.
  • Ruetten S, Komp M, Merk H, et al. Full-endoscopic cervical posterior foraminotomy for the operation of lateral disc herniations using 5.9-mm endoscopes: a prospective, randomized, controlled study. Spine. 1976;2008;33(9):940-8.
  • Ji-jun, H, Hui-hui S, Zeng-wu S, et al. Posterior full-endoscopic cervical discectomy in cervical radiculopathy: a prospective cohort study. Clin. Neurol. Neurosurg. 2020; 195:105948.
  • Padhye K, Shultz P, Alcala C, et al. Surgical treatment of single level cervical radiculopathy: a comparison of anterior cervical decompression and fusion (ACDF) versus cervical disk arthroplasty (CDA) versus posterior cervical foraminotomy (PCF). Clin Spine Surg Spine. 2022; 35: 149–54.
  • Herkowitz HN, Kurz LT, Overholt DP. Surgical management of cervical soft disc herniation: a comparison between the anterior and posterior approach. Spine. 1990;15(10):1026–30.
  • Wirth FP, Dowd GC, Sanders HF, Wirth C. Cervical discectomy. A prospective analysis of three operative techniques. Surg Neurol. 2000;53(4):340–6.
  • Fang H, Cui M, Zhao K, et al. Minimally invasive posterior cervical foraminotomy versus anterior cervical fusion and arthroplasty: Systematic review and updated meta-analysis. Brain and Spine.2024;4:102852.
  • Lin GX, Rui G, Sharma S, et al. Does the neck pain, function, or range of motion differ after anterior cervical fusion, cervical discreplacement, and posterior cervical foraminotomy? World Neurosurg. 2019;129: e485–93.
  • Padhye K, Shultz P, Alcala C, et al. Surgical treatment of single level cervical radiculopathy. Clinical Spine Surgery. 2022;35(4):149–54.
  • Santangelo G, Wathen C, Macaluso D, et al. Comparison of Single-Level Posterior Cervical Foraminotomy to Anterior Cervical Discectomy and Fusion for Radiculopathy. Int J Spine Surg. 2023;17(3):418-25.
  • Wang TY, Lubelski D, Abdullah KG,et al. Rates of anterior cervical discectomy and fusion after initial posterior cervical foraminotomy. Spine J. 2015;15(5):971–6.
  • Ruetten S, Komp M, Merk H, et al. Full-endoscopic cervical posterior foraminotomy for the operation of lateral disc herniations using 5.9-mm endoscopes: a prospective, randomized, controlled study. Spine. 2008;33(9):940-8.
There are 17 citations in total.

Details

Primary Language English
Subjects Clinical Sciences (Other)
Journal Section Original Article
Authors

Güven Gürsoy 0000-0001-8374-7916

Gönül Güvenç 0000-0002-9382-8610

Publication Date August 28, 2025
Submission Date February 19, 2025
Acceptance Date April 17, 2025
Published in Issue Year 2025 Volume: 12 Issue: 2

Cite

APA Gürsoy, G., & Güvenç, G. (2025). Anterior Cervical Discectomy and Fusion vs Posterior Key-Hole Foraminotomy in Single Level Cervical Discopathy. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, 12(2), 174-178. https://doi.org/10.47572/muskutd.1642620
AMA Gürsoy G, Güvenç G. Anterior Cervical Discectomy and Fusion vs Posterior Key-Hole Foraminotomy in Single Level Cervical Discopathy. MMJ. August 2025;12(2):174-178. doi:10.47572/muskutd.1642620
Chicago Gürsoy, Güven, and Gönül Güvenç. “Anterior Cervical Discectomy and Fusion Vs Posterior Key-Hole Foraminotomy in Single Level Cervical Discopathy”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 12, no. 2 (August 2025): 174-78. https://doi.org/10.47572/muskutd.1642620.
EndNote Gürsoy G, Güvenç G (August 1, 2025) Anterior Cervical Discectomy and Fusion vs Posterior Key-Hole Foraminotomy in Single Level Cervical Discopathy. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 12 2 174–178.
IEEE G. Gürsoy and G. Güvenç, “Anterior Cervical Discectomy and Fusion vs Posterior Key-Hole Foraminotomy in Single Level Cervical Discopathy”, MMJ, vol. 12, no. 2, pp. 174–178, 2025, doi: 10.47572/muskutd.1642620.
ISNAD Gürsoy, Güven - Güvenç, Gönül. “Anterior Cervical Discectomy and Fusion Vs Posterior Key-Hole Foraminotomy in Single Level Cervical Discopathy”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 12/2 (August2025), 174-178. https://doi.org/10.47572/muskutd.1642620.
JAMA Gürsoy G, Güvenç G. Anterior Cervical Discectomy and Fusion vs Posterior Key-Hole Foraminotomy in Single Level Cervical Discopathy. MMJ. 2025;12:174–178.
MLA Gürsoy, Güven and Gönül Güvenç. “Anterior Cervical Discectomy and Fusion Vs Posterior Key-Hole Foraminotomy in Single Level Cervical Discopathy”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, vol. 12, no. 2, 2025, pp. 174-8, doi:10.47572/muskutd.1642620.
Vancouver Gürsoy G, Güvenç G. Anterior Cervical Discectomy and Fusion vs Posterior Key-Hole Foraminotomy in Single Level Cervical Discopathy. MMJ. 2025;12(2):174-8.