Minimally invasive 2-level posterior cervical foraminotomy: preliminary clinical results

INTRODUCTION: The management of cervical radiculopathy has undergone significant evolution, and the most recent advancement is the integration of minimally invasive surgical techniques. There have been relatively few reports in the medical literature describing the clinical results of minimally invasive cervical spine surgery. The authors describe the surgical indications, technique, and preliminary clinical outcomes in a series of patients who underwent the 2-level minimally invasive posterior cervical foraminotomy procedure. METHODS: This report is composed of 21 consecutive patients with cervical radiculopathy who underwent a minimally invasive 2-level posterior cervical foraminotomy at our institution between 2003 and 2005. Magnetic resonance imaging demonstrated foraminal or posterolateral pathology at 2 ipsilateral adjacent spinal levels in each patient. Radicular arm pain was the most common presenting symptom, and was encountered in all 21 patients. RESULTS: The mean follow up for the patients was 23 months (range 12 to 36). Complete resolution of preoperative symptoms was achieved in 19 out of 21 patients (90%). Sixteen patients were discharged home the same day of surgery, and the mean estimated blood loss was 35 mL (range 10 to 100 mL). There were no perioperative complications. CONCLUSIONS: Minimally invasive 2-level posterior cervical foraminotomy can be safely performed on an outpatient basis with results comparable to that of conventional foraminotomy. This procedure should be considered as a potential alternative to 2-level anterior cervical discectomy and fusion or open foraminotomy in selected patients.