• Daisuke Umebayashi, Masahito Hara, Yasuhiro Nakajima, Yusuke Nishimura, and Toshihiko Wakabayashi.
• Department of Neurosurgery, Nagoya University School of Medicine, Nagoya, Aichi, 466-8550, Japan, umebayad@gmail.com.
• Eur Spine J. 2013 Dec 1;22(12):2884-90.

PurposeThe aim of this study was to compare the clinical features, radiological changes, biomechanical effects, and efficacy in patients treated by transvertebral anterior foraminotomy. Preservation of segmental motion and avoidance of adjacent segment degeneration are theoretical advantages of transvertebral anterior foraminotomy. In practice, this procedure is minimally invasive and has shown good clinical results, especially in patients with unilateral cervical radiculopathy.MethodWe conducted a retrospective minimum 2-year follow-up study of the cervical spine of patients treated by transvertebral anterior foraminotomy at our institution. Radiological outcomes, which were estimated by measuring disc and functional spinal unit heights, and the angle and range of motion (ROM) from C2 to C7 of the functional spinal unit and adjacent segments were evaluated. Furthermore, a three-dimensional finite element method was used to biomechanically analyze the strength of the postoperative vertebral body.ResultsBetween 2004 and 2009, 34 patients underwent surgery. The improvement rate was 94.2 %. The average flexion-extension ROM from C2 to C7 was 36.6 ± 16.6°. On plain radiographs, the disc height and ROM and height of the functional spinal unit in the operated segment were not significantly decreased relative to the preoperative levels. The finite element method also revealed that there was no difference in strength between the pre- and postvertebral bodies.ConclusionsThese results demonstrate that biomechanical stability was achieved. Transvertebral anterior cervical foraminotomy did not limit motion in the operated and adjacent segments and did not cause a significant decrease in disc and vertebral heights after surgery.

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