PMID- 30450995
OWN - NLM
STAT- MEDLINE
DCOM- 20190422
LR  - 20190422
IS  - 1360-046X (Electronic)
IS  - 0268-8697 (Linking)
VI  - 33
IP  - 1
DP  - 2019 Feb
TI  - Comparison of clinical outcomes in anterior cervical discectomy versus 
      foraminotomy for brachialgia.
PG  - 3-7
LID - 10.1080/02688697.2018.1527013 [doi]
AB  - AIM: The choice between anterior cervical discectomy & fusion (ACD) or posterior 
      cervical foraminotomy (PCF) for the treatment of cervical brachialgia is 
      controversial. This study aimes to compare clinical outcomes between these two 
      operative inteventions for brachialgia. METHODS: Retrospective review of 
      prospectively collected data was performed. Patients receiving a primary ACD or 
      PCF to treat brachialgia, in a single tertiary neurosurgical unit were included. 
      Surgical details, and patient reported outcomes (COMI-Neck questionnaire) were 
      extracted from a prospectively maintained spinal procedure database. Minimum 
      clinically important difference (MCID) was defined as a change in COMI score of 
      -2 at 12 months. The student t-test, Chi-square test, and linear regression were 
      used to compare groups. RESULTS: Between June 2011 ad February 2016 there were 
      634 ACD procedures (Median age 49; 321 Male), and 54 PCF procedures (Median age 
      50; 37 Male) perfomed for brachialgia. Age, ASA and pre-operative COMI were 
      similar between the groups (p > .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 < .01). Mean change in COMI 
      at 3 months was -2.38 for ACD, versus -2.31 for PCF (p = .88); at twelve months 
      it was -2.94 for ACD, versus -2.67 for PCF (p = .55). MCID was seen in 59% of ACD 
      cases, versus 58% of PCF cases at twelve months (p = .91). CONCLUSION: There was 
      no significant difference between outcomes in the ACD and PCF groups. This is 
      supportive of published literature. The proposed multicenter RCTs may inform 
      further.
FAU - Foster, Mitchell T
AU  - Foster MT
AUID- ORCID: 0000-0001-6827-9472
AD  - a Department of Neurosurgery , The Walton Centre NHS Foundation Trust , Liverpool 
      , UK.
FAU - Carleton-Bland, Nicholas P
AU  - Carleton-Bland NP
AD  - a Department of Neurosurgery , The Walton Centre NHS Foundation Trust , Liverpool 
      , UK.
FAU - Lee, Maggie K
AU  - Lee MK
AD  - a Department of Neurosurgery , The Walton Centre NHS Foundation Trust , Liverpool 
      , UK.
FAU - Jackson, Richard
AU  - Jackson R
AD  - b Cancer Research UK Liverpool Cancer Trials Unit , University of Liverpool , 
      Liverpool , UK.
FAU - Clark, Simon R
AU  - Clark SR
AD  - a Department of Neurosurgery , The Walton Centre NHS Foundation Trust , Liverpool 
      , UK.
FAU - Wilby, Martin J
AU  - Wilby MJ
AD  - a Department of Neurosurgery , The Walton Centre NHS Foundation Trust , Liverpool 
      , UK.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
PT  - Video-Audio Media
DEP - 20181119
PL  - England
TA  - Br J Neurosurg
JT  - British journal of neurosurgery
JID - 8800054
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cervical Vertebrae/surgery
MH  - Diskectomy/*methods
MH  - Female
MH  - Foraminotomy/*methods
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neck Dissection/methods
MH  - Neuralgia/*surgery
MH  - Operative Time
MH  - Prospective Studies
MH  - Radiculopathy/*surgery
MH  - Retrospective Studies
MH  - Spinal Fusion/*methods
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - ACD
OT  - ACDF
OT  - Anterior cervical discectomy
OT  - PCF
OT  - Posterior cervical foraminotomy
OT  - brachialgia
OT  - cervical disc prolapse
OT  - cervical foraminotomy
OT  - degenerative cervical disc
EDAT- 2018/11/20 06:00
MHDA- 2019/04/23 06:00
CRDT- 2018/11/20 06:00
PHST- 2018/11/20 06:00 [pubmed]
PHST- 2019/04/23 06:00 [medline]
PHST- 2018/11/20 06:00 [entrez]
AID - 10.1080/02688697.2018.1527013 [doi]
PST - ppublish
SO  - Br J Neurosurg. 2019 Feb;33(1):3-7. doi: 10.1080/02688697.2018.1527013. Epub 2018 
      Nov 19.