Transcorporeal Tunnel Approach for Unilateral Cervical Radiculopathy: A 2-Year Follow-up Review and Results
Presented at SMISS Annual Forum 2013
By Gun Choi MD, PhD
Disclosures: Gun Choi MD, PhD C; joimax.
Introduction: The long-term complications of traditional discectomy and fusion surgery have led to the need for minimally invasive procedures that do not require a complete discectomy and fusion. Jho developed an anterior unco-foraminotomy that we have modified, with the approach being more medial than that of Jho, into an anterior transcorporeal tunnel approach which we use for cervical spondylotic unilateral radiculopathy.
Methods: A retrospective analysis was carried out in 57 patients who underwent a transcorporeal "tunnel" anterior micro-foraminotomy for unilateral radicular symptoms with a follow-up more than 2 years. All were operated by a single surgeon using the same technique from the vertebral body proximal to the lesion and proceeding downwards to the herniation. At final follow-up we reviewed the clinical and radiological results.
Results: All patients in the immediate post-operative period showed relief of their symptoms, and there were major complications. 3 patients complained about the numbness in the immediate postoperative period which resolved within 3 months. There was a significant improvement in NDI from pre-operative 61.83% to postoperative 12.22% (P<0.001). Average pre-operative VAS scores for arm and neck were 7.83 and 6.15, respectively; which improved to 1.32 and 1.45 (P<0.001) postoperatively. There was an average 9% decrease (from 7.8 mm to 7.3 mm) in the post-operative disc height compared to the preoperative disc height; however, it was clinically and radiologically insignificant. The long-term results were favourable and there were no major complications.
Conclusion: The transcorporeal tunnel approach can be used as an alternative treatment for cervical spondylotic radiculopathy.