Anterior cervical foraminotomy represents a relatively recent minimally invasive approach that can potentially preserve the intervertebral disc and thus the functional motion segment. This study aims to evaluate the clinical outcome of microendoscopic anterior cervical foraminotomy (MACF) for patients with cervical unilateral radiculopathy due to single level soft disc herniation or hard disc-osteophyte complex (DOC). In the period between August 2009 and March 2015, 76 consecutive patients with symptomatic unilateral cervical radiculopathy were included in this study. There were 40 left-sided cervical radiculopathy cases and 36 right-sided; of those, 42 had soft disc fragment herniation, 18 had DOC, 12 had a migrated disc fragment whether cranial or caudal, and four had far lateral (foraminal) disc herniation. In all cases, MACF with root decompression was performed. Cervical magnetic resonance imaging (MRI), computed tomography (CT) scan, and plain X-rays were performed for all patients and then repeated postoperatively. All patients were followed-up for at least a year. Clinical and functional outcomes were assessed using visual analogue scale (VAS) and Odom’s criteria. According to VAS score, there was an improvement in neck pain from 6.4 (range 5–10) to 1.5 (1–5) and in arm pain from 7.2 (range 6–10) to 1.2 (0–4) at final follow-up (P < 0.05). Functional outcomes according to Odom’s criteria were excellent in 59 (78%) cases, good in ten (13%), fair in six (8%), and poor in one (1%) case. Success of surgery was considered to be achieved in 91% (excellent + good) of cases. Mean operating time was 81 min, and mean intraoperative blood loss was 21 ml. Most significant complications included a dural tear in one case, transient postoperative dysesthesia in six cases, excess bony work resulting in unintended uncinectomy in three cases, fracture of transverse process in one case, unintended near total discectomy in two cases, infective discitis in one case, and persistent radicular pain due to incomplete osteophyte removal in one case. This preliminary report suggests that MACF yields overall excellent results in selected patients with unilateral cervical radiculopathy. The technique potentially can preserve the functional motion segment, thus patients typically experience immediate postoperative neck mobility and do not need to wear a cervical collar.

中文翻译：

---

显微内镜颈前路椎间孔切开术：初步治疗76例

颈椎前路开孔术是一种相对较新的微创方法，可以潜在地保留椎间盘并因此保留功能性运动节段。这项研究的目的是评估由于单级软性椎间盘突出症或硬性椎体-骨赘复合物（DOC）而导致的颈侧单侧神经根病变的患者的显微内镜颈前路椎间孔切开术（MACF）的临床结果。在2009年8月至2015年3月期间，本研究纳入了76例有症状的单侧颈神经根神经病患者。左侧颈神经根病40例，右侧36例。其中42例患有软性椎间盘突出症，18例具有DOC，12例具有迁移性椎间盘碎片（无论是颅骨还是尾状），还有四个具有远侧（椎间孔）椎间盘突出症。在所有情况下，进行根减压的MACF。对所有患者进行宫颈磁共振成像（MRI），计算机断层扫描（CT）扫描和X线平片检查，然后在术后重复进行。所有患者均接受了至少一年的随访。使用视觉模拟量表（VAS）和Odom的标准评估临床和功能结局。根据VAS评分，在最终随访中，颈部疼痛从6.4（5-10）提高到1.5（1-5），手臂疼痛从7.2（6-10）提高到1.2（0-4）。上升（P <0.05）。根据Odom的标准，功能预后良好（59例（78％），好（10％）（13％），一般（6）（8％），较差（1％）。91％（优秀+良好）的病例被认为手术成功。平均手术时间为81分钟，平均术中失血量为21毫升。最重要的并发症包括：硬脑膜撕裂1例，术后短暂感觉异常6例，过多的骨力劳动导致意外的非癌切除术3例，横突骨折1例，意外的近全椎间盘切除术2例，感染性椎间盘炎1例一例由于未完全去除骨赘而引起的持续性根性疼痛。该初步报告表明，MACF在选定的单侧颈神经根病患者中获得总体优异的结果。该技术潜在地可以保留功能性运动段，因此患者通常会立即经历术后颈部活动性，并且不需要戴颈托。过多的骨工作导致3例意外切开癌，1例横突骨折，2例意外近全椎间盘切除，1例感染性圆盘炎和1例由于未完全去除骨赘而引起的持续性根源性疼痛。该初步报告表明，MACF在选定的单侧颈神经根病患者中获得总体优异的结果。该技术潜在地可以保留功能性运动段，因此患者通常会立即经历术后颈部活动性，并且不需要戴颈托。过多的骨工作导致3例意外切开癌，1例横突骨折，2例意外近全椎间盘切除，1例感染性圆盘炎和1例由于未完全去除骨赘而引起的持续性根源性疼痛。该初步报告表明，MACF在选定的单侧颈神经根病患者中获得总体优异的结果。该技术潜在地可以保留功能性运动段，因此患者通常会立即经历术后颈部活动性，并且不需要戴颈托。该初步报告表明，MACF在选定的单侧颈神经根病患者中获得总体优异的结果。该技术潜在地可以保留功能性运动段，因此患者通常会立即经历术后颈部活动性，并且不需要戴颈托。该初步报告表明，MACF在选定的单侧颈神经根病患者中获得总体优异的结果。该技术潜在地可以保留功能性运动段，因此患者通常会立即经历术后颈部活动性，并且不需要戴颈托。