Perspective: Cervical laminoforaminotomy (CLF) is safer than anterior cervical diskectomy/fusion (ACDF) for lateral cervical disease

Author:

Epstein Nancy E.1,Agulnick Marc A.2

Affiliation:

1. Professor of Clinical Neurosurgery, School of Medicine, State University of NY at Stony Brook and Editor-in-Chief Surgical Neurology International NY, USA, and c/o Dr. Marc Agulnick, 1122 Franklin Avenue Suite 106, Garden City, NY, USA,

2. Assistant Clinical Professor of Orthopedics, NYU Langone Hospital, Long Island, NY, USA, 1122 Frankling Avenue Suite 106, Garden City, NY, USA.

Abstract

Background: The literature documents that laminoforaminotomy (CLF), whether performed open, minimally invasively, or microendoscopically, is safer than anterior cervical diskectomy/fusion (ACDF) for lateral cervical disease. Methods: ACDF for lateral cervical disc disease and/or spondylosis exposes patients to multiple major surgical risk factors not encountered with CLF. These include; carotid artery or jugular vein injuries, esophageal tears, dysphagia, recurrent laryngeal nerve injuries, tracheal injuries, and dysphagia. CLF also exposes patients to lower rates of vertebral artery injury, dural tears (DT)/cerebrospinal fluid fistulas, instability warranting fusion, adjacent segment disease (ASD), plus cord and/or nerve root injuries. Results: Further, CLF vs. ACDF for lateral cervical pathology offer reduced tissue damage, operative time, estimated blood loss (EBL), length of stay (LOS), and cost. Conclusion: CLFs’, whether performed open, minimally invasively, or microendoscopically, offer greater safety, major pros with few cons, and decreased costs vs. ACDF for lateral cervical disease.

Publisher

Scientific Scholar

Reference17 articles.

1. Microendoscopic posterior cervical laminoforaminotomy for unilateral radiculopathy: Results of a new technique in 100 cases;Adamson;J Neurosurg,2001

2. Treatment of cervical radiculopathy: A review of the evolution and economics;Ament;Surg Neurol Int,2018

3. Cervical laminoforaminotomy for radiculopathy: Symptomatic and functional outcomes in a large cohort with long-term follow-up;Church;Surg Neurol Int,2014

4. A review of laminoforaminotomy for the management of lateral and foraminal cervical disc herniations or spurs;Epstein;Surg Neurol,2002

5. Open laminoforaminotomy: A lost art?;Epstein;Surg Neurol Int,2015

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