1Dr. Furqan Ahmad, 2Umar Shahzad, 3Hadi Kamran, 4Mohib Ali, 5Hassan Raza, 6Dr. Fizza Farooq, 7Kashif Lodhi
1Department of Diagnostic and Intervention Radiology, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat-Pakistan
2PIMS
3PIMS
4PIMS
5PIMS
6Emergency Department, Bakhtawar Hospital, Sadiqabad -Pakistan
7Department of Agricultural, Food and Environmental Sciences. Università Politécnica delle Marche Via Brecce Bianche 10, 60131 Ancona (AN) Italy
ABSTRACT:
Background: Anterior Cervical Discectomy and Fusion (ACDF) is a common surgical procedure for the treatment of cervical disc herniation, degenerative disc disease, and radiculopathy. However, traditional ACDF may require additional interventions, such as foraminotomy, to address foraminal stenosis. Uncoforaminotomy is a less invasive technique that involves resection of the uncinate process and part of the uncovertebral joint, providing an alternative to traditional foraminotomy during ACDF.
Aim: This study aims to assess the clinical and radiographic outcomes of patients who underwent uncoforaminotomy ACDF.
Methods: A retrospective analysis was conducted on a cohort of patients who underwent uncoforaminotomy ACDF at our institution. Clinical data including preoperative symptoms, postoperative complications, and follow-up evaluations were collected. Radiographic assessments, including preoperative and postoperative imaging studies, were analyzed to evaluate foraminal decompression and fusion success. Visual Analog Scale (VAS) scores, Neck Disability Index (NDI) scores, and Odom’s criteria were used to assess clinical outcomes.
Results: A total of 65 patients were included in the study with a mean follow-up period of 24 months. The majority of patients (83.1%) reported significant improvement in their VAS scores for neck and arm pain postoperatively. NDI scores also showed substantial improvement, indicating enhanced neck function and reduced disability. Radiographic analysis revealed successful decompression of the neural foramina and adequate fusion in 92.3% of the cases. Only a few patients experienced minor complications, such as postoperative dysphagia, which resolved within a few weeks.
Conclusion: Uncoforaminotomy ACDF appears to be a safe and effective surgical approach for patients with cervical disc herniation and foraminal stenosis. The procedure provides excellent foraminal decompression and promotes successful fusion, leading to significant improvement in clinical outcomes. The technique offers an alternative to traditional foraminotomy, reducing the risk of neural injury and minimizing postoperative complications. Further long-term studies with larger patient cohorts are warranted to validate these findings.
Keywords: Uncoforaminotomy, Anterior Cervical Discectomy and Fusion, ACDF, cervical disc herniation, foraminal stenosis, clinical outcomes, radiographic outcomes, VAS scores, NDI scores, fusion success.