Author(s): Foster M.; Carleton-Bland N.; Lee M.; Clark S.; Sarsam Z.; Wilby M.
Source: British Journal of Neurosurgery; 2018; vol. 32 (no. 1); p. 78
Publication Date: 2018
Publication Type(s): Conference Abstract
Abstract:Objectives: The choice between anterior cervical discectomy & fusion (ACD) or posterior cervical foraminotomy (PCF) for the treatment of cervical brachialgia is controversial. Design: Retrospective review of prospectively collected data. Subjects: Patients receiving a primary ACD or PCF to treat brachialgia, in a single institution. Methods: Surgical details, and patient reported outcomes (COMI-Neck for) were extracted from our database of spinal procedures. Minimum clinically important difference (MCID) was defined as a change in COMI score of-2. The student t-test, Chi-square test, and logistic regression were used to compare groups. Results: Between and June 2011 and February 2016 there were 634 ACD procedures (Median age 49, 321 Male), and 54 PCF procedures (Median age 50, 37 Male) performed for brachialgia. Age, ASA and pre-operative COMI were similar between the groups (p > 0.05). Complete outcome data was recorded at twelve months in 312 ACD and 36 PCF patients. Both ACD and PCF were associated with an improvement in COMI at 3 and 12 months (all p<0.01). Mean change in COMI at 3 months was-2.38 for ACD, versus-2.31 for PCF (p = 0.88); at twelve months it was-2.94 for ACD, versus-2.67 for PCF (p = 0.55). MCID was seem in 50% of ACD cases, versus 56% of PCF cases at three months (p = 0.52), and 59% of ACD cases, versus 58% of PCF cases at twelve months (p = 0.91). Age, gender, BMI and smoking status did not signifi-cantly relate to outcome (p > 0.05). Conclusions: There was no significant difference between outcomes in the ACD and PCF groups.