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Long-term clinical and radiologic outcomes of minimally invasive posterior cervical foraminotomy.

Kwon YJ - J Korean Neurosurg Soc (2014)

Bottom Line: VAS scores for neck/shoulder and arm improved significantly in the early postoperative period (3 months) and were maintained with time (p<0.001).NDI improved significantly post-operatively and tended to decrease gradually during the follow-up period (p<0.001).There were no statistically significant changes in focal and global angulation at follow-up.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Objective: To report long-term clinical and radiological outcomes of minimally invasive posterior cervical foraminotomy (MI-PCF) performed in patients with unilateral single-level cervical radiculopathy.

Methods: Of forty-six patients who underwent MI-PCF for unilateral single-level radiculopathy between 2005 and 2013, 33 patients were included in the study, with a mean follow-up of 32.7 months. Patients were regularly followed for clinical and radiological assessment. Clinical outcome was measured by visual analogue scale (VAS) for the neck/shoulder and arm, and the neck disability index (NDI). Radiological outcome was measured by focal/global angulation and disc height index (DHI). Outcomes after MI-PCF were evaluated as changes of clinical and radiological parameters from the baseline. Mixed effect model with random patients' effect was used to test for differences in the clinical and radiological parameters repeat measures.

Results: There were no complications and all patients had an uneventful recovery during the early postoperative period. VAS scores for neck/shoulder and arm improved significantly in the early postoperative period (3 months) and were maintained with time (p<0.001). NDI improved significantly post-operatively and tended to decrease gradually during the follow-up period (p<0.001). There were no statistically significant changes in focal and global angulation at follow-up. Percent DHIs of the upper adjacent or operated disc were maintained without significant changes with time. During the follow-up, same site recurrence was not noted and adjacent segment disease requiring additional surgery occurred in two patients (6%) on the contra-lateral side.

Conclusion: MI-PCF provides long-term pain relief and functional restoration, accompanied by good long-term radiological outcome.

No MeSH data available.


Related in: MedlinePlus

Clinical outcomes measured by visual analogue scale (VAS) and neck disability index (NDI). VAS scores of neck/shoulder (nVAS) (A) and arm (aVAS) (B) decrease immediately in the early post-operative period and maintain at plateau with time. NDI (C) tends to decrease more gradually over the follow-up period. The bottom and top of the box are the first quartile and third quartile, and the band inside the box is the median. The circles represent outliers beyond 1.5 interquartile ranges.
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Figure 2: Clinical outcomes measured by visual analogue scale (VAS) and neck disability index (NDI). VAS scores of neck/shoulder (nVAS) (A) and arm (aVAS) (B) decrease immediately in the early post-operative period and maintain at plateau with time. NDI (C) tends to decrease more gradually over the follow-up period. The bottom and top of the box are the first quartile and third quartile, and the band inside the box is the median. The circles represent outliers beyond 1.5 interquartile ranges.

Mentions: Mean baseline VAS scores of neck/shoulder (nVAS), VAS scores of arm (aVAS), and NDI were 5.3 (median, 5.5; IQR, 4.0-7.0), 5.4 (median, 5.5; IQR, 4.0-7.0), and 35.6 (median, 34.8; IQR, 24.9-42.7), respectively. The 3-month follow-up values [nVAS; 1.7 (median, 2.0; IQR, 0.0-3.0), aVAS; 1.6 (median, 1.0; IQR, 0.0-3.0), NDI; 14.7 (median, 13.3; IQR, 4.4-16.0)] showed significant improvements vs. the baseline values (p<0.001, respectively). Long-term trend analysis using the mixed-effect model showed that both VAS scores improved significantly in the early post-operative period (3 months) and maintained at plateau with time, and NDI improved significantly post-operatively and tended to decrease more gradually over the follow-up period (p<0.001) (Fig. 2).


Long-term clinical and radiologic outcomes of minimally invasive posterior cervical foraminotomy.

Kwon YJ - J Korean Neurosurg Soc (2014)

Clinical outcomes measured by visual analogue scale (VAS) and neck disability index (NDI). VAS scores of neck/shoulder (nVAS) (A) and arm (aVAS) (B) decrease immediately in the early post-operative period and maintain at plateau with time. NDI (C) tends to decrease more gradually over the follow-up period. The bottom and top of the box are the first quartile and third quartile, and the band inside the box is the median. The circles represent outliers beyond 1.5 interquartile ranges.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4217059&req=5

Figure 2: Clinical outcomes measured by visual analogue scale (VAS) and neck disability index (NDI). VAS scores of neck/shoulder (nVAS) (A) and arm (aVAS) (B) decrease immediately in the early post-operative period and maintain at plateau with time. NDI (C) tends to decrease more gradually over the follow-up period. The bottom and top of the box are the first quartile and third quartile, and the band inside the box is the median. The circles represent outliers beyond 1.5 interquartile ranges.
Mentions: Mean baseline VAS scores of neck/shoulder (nVAS), VAS scores of arm (aVAS), and NDI were 5.3 (median, 5.5; IQR, 4.0-7.0), 5.4 (median, 5.5; IQR, 4.0-7.0), and 35.6 (median, 34.8; IQR, 24.9-42.7), respectively. The 3-month follow-up values [nVAS; 1.7 (median, 2.0; IQR, 0.0-3.0), aVAS; 1.6 (median, 1.0; IQR, 0.0-3.0), NDI; 14.7 (median, 13.3; IQR, 4.4-16.0)] showed significant improvements vs. the baseline values (p<0.001, respectively). Long-term trend analysis using the mixed-effect model showed that both VAS scores improved significantly in the early post-operative period (3 months) and maintained at plateau with time, and NDI improved significantly post-operatively and tended to decrease more gradually over the follow-up period (p<0.001) (Fig. 2).

Bottom Line: VAS scores for neck/shoulder and arm improved significantly in the early postoperative period (3 months) and were maintained with time (p<0.001).NDI improved significantly post-operatively and tended to decrease gradually during the follow-up period (p<0.001).There were no statistically significant changes in focal and global angulation at follow-up.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Objective: To report long-term clinical and radiological outcomes of minimally invasive posterior cervical foraminotomy (MI-PCF) performed in patients with unilateral single-level cervical radiculopathy.

Methods: Of forty-six patients who underwent MI-PCF for unilateral single-level radiculopathy between 2005 and 2013, 33 patients were included in the study, with a mean follow-up of 32.7 months. Patients were regularly followed for clinical and radiological assessment. Clinical outcome was measured by visual analogue scale (VAS) for the neck/shoulder and arm, and the neck disability index (NDI). Radiological outcome was measured by focal/global angulation and disc height index (DHI). Outcomes after MI-PCF were evaluated as changes of clinical and radiological parameters from the baseline. Mixed effect model with random patients' effect was used to test for differences in the clinical and radiological parameters repeat measures.

Results: There were no complications and all patients had an uneventful recovery during the early postoperative period. VAS scores for neck/shoulder and arm improved significantly in the early postoperative period (3 months) and were maintained with time (p<0.001). NDI improved significantly post-operatively and tended to decrease gradually during the follow-up period (p<0.001). There were no statistically significant changes in focal and global angulation at follow-up. Percent DHIs of the upper adjacent or operated disc were maintained without significant changes with time. During the follow-up, same site recurrence was not noted and adjacent segment disease requiring additional surgery occurred in two patients (6%) on the contra-lateral side.

Conclusion: MI-PCF provides long-term pain relief and functional restoration, accompanied by good long-term radiological outcome.

No MeSH data available.


Related in: MedlinePlus