The clinical and economic costs of treating cervical radiculopathy: The age-old question of the anterior versus posterior approach

Anthony C. Lau, Michael Y. Wang

Research output: Contribution to journalEditorialpeer-review

Abstract

In this article, Nguyen et al.8 explore the differences between anterior cervical discectomy and fusion (ACDF) and posterior cervical foraminotomy (PCF) with respect to the postoperative neural foramen size in a cadaveric model. They report that PCF results in a significantly larger neural foramen compared with the untreated control group. This larger foramen size persisted in flexion and extension of the cervical spine when compared with controls. In ACDF-treated specimens, the foramen size did not change significantly compared with untreated controls, even with resection of the posterior one-third of the uncovertebral joint. Foramen size was significantly decreased in the extension position with ACDF and uncovertebral joint resection, supporting the notion that anterior cervical discectomies without upfront fusions are inherently unstable. Although these findings seem to favor the PCF as the superior technique biomechanically, the authors in their discussion correctly acknowledge the fact that the clinical outcomes of the ACDF and PCF appear to be equivalent. They further postulate that the postsurgical resolution of pain is possibly less related to the postoperative foramen size, than to the alleviation of compression of vascular structures that were causing radicular artery ischemia or venous congestion.

Original languageEnglish (US)
Pages (from-to)617-618
Number of pages2
JournalJournal of Neurosurgery: Spine
Volume27
Issue number6
DOIs
StatePublished - Dec 2017

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology

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