Comparison of anterior spinal fusion and posterior cervical foraminotomy for cervical spondylotic radiculopathy in terms of postoperative recovery of upper-limb motor deficits.

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  • Additional Information
    • Source:
      Publisher: Churchill Livingstone Country of Publication: Scotland NLM ID: 9433352 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-2653 (Electronic) Linking ISSN: 09675868 NLM ISO Abbreviation: J Clin Neurosci Subsets: MEDLINE
    • Publication Information:
      Publication: <2000->: Edinburgh : Churchill Livingstone
      Original Publication: Melbourne, Vic., Australia : Churchill Livingstone, c1994-
    • Subject Terms:
      Radiculopathy*/surgery ; Radiculopathy*/physiopathology ; Spinal Fusion*/methods ; Recovery of Function*/physiology ; Spondylosis*/surgery ; Spondylosis*/complications ; Foraminotomy*/methods ; Upper Extremity*/surgery ; Upper Extremity*/physiopathology ; Cervical Vertebrae*/surgery; Humans ; Male ; Female ; Middle Aged ; Aged ; Treatment Outcome ; Adult ; Retrospective Studies ; Follow-Up Studies
    • Abstract:
      This study compared postoperative motor recovery between anterior spinal fusion (ASF) and posterior cervical foraminotomy (PCF) in patients with cervical spondylotic radiculopathy (CSR) who had motor deficits. From a database maintained by surgeons across 27 institutions, 227 patients undergoing primary ASF or PCF for CSR without myelopathy were evaluated. Among these, 106 patients with upper-limb motor deficits (manual muscle testing [MMT] grade 0-3) were observed for at least 12 months post-surgery. Data on preoperative and postoperative MMT grades were collected at 3, 6, and 12 months after surgery and at the final follow-up. The recovery of motor function was compared between the ASF and PCF groups using Kaplan-Meier curves and Cox regression analysis. While the overall excellent recovery rates (MMT grade ≥ 2) at the final follow-up were similar between the ASF and PCF group (74 % vs. 86 %, p = 0.15), the PCF group showed significantly faster motor recovery at 3, 6, and 12 months postoperatively, with recovery rates of 43 %, 63 %, and 82 %, respectively, compared to 18 %, 46 %, and 54 % in the ASF group (HR = 1.62, p = 0.031). These findings suggest that PCF may offer a quicker recovery of motor function and could be a more suitable surgical procedure than ASF for patients with CSR and motor deficits.
      Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
      (Copyright © 2024 Elsevier Ltd. All rights reserved.)
    • Contributed Indexing:
      Keywords: Anterior spinal fusion; Cervical spondylotic radiculopathy; Foraminotomy; Motor recovery; Surgeon-maintained database
    • Publication Date:
      Date Created: 20241018 Date Completed: 20241031 Latest Revision: 20241031
    • Publication Date:
      20241101
    • Accession Number:
      10.1016/j.jocn.2024.110873
    • Accession Number:
      39423486