• World Neurosurg · Jan 2019

    Facetal fixation-arthrodesis as treatment for cervical radiculopathy.

    • Atul Goel, Pralhad Dharurkar, Abhidha Shah, Sandeep Gore, Nilesh Bakale, and Tejas Vaja.
    • Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Mumbai, India; Department of Neurosurgery, Lilavati Hospital and Research Centre, Mumbai, India. Electronic address: atulgoel62@hotmail.com.
    • World Neurosurg. 2019 Jan 1; 121: e875-e881.

    ObjectiveWe assessed the efficacy of "only fixation" as treatment for cervical radiculopathy.MethodsFrom 2012 to December 2017, 21 patients who had presented with primary symptoms related to cervical radiculopathy, including radiating pain, tingling paresthesia, numbness, weakness, and wasting were treated by facetal stabilization surgery aimed at achieving segmental arthrodesis. No decompression by removal of bone, disc material, or osteophyte was performed. The age of the patients ranged from 27 to 59 years. Of the 21 patients, 19 were men and 2 were women. The imaging findings showed a herniated disc in 4, a disc bulge in 12, and osteophyte-related foraminal stenosis in 5 patients. Transarticular screw fixation was deployed for surgery. The levels of cervical fixation were guided by the clinical and radiological information and determined by direct observation of the facet morphology and stability by manual manipulation of the bones in the region.ResultsAll the patients experienced "remarkable" relief of the presenting radicular symptoms in the "immediate" postoperative period. The visual analog scale and neck disability index scores were used to assess the patients before and after surgical treatment. During the follow-up period, which ranged from 6 to 64 months, all the patients continued to experience satisfactory symptomatic relief.ConclusionsInstability of the spinal segment is the nodal point of pathogenesis and the primary cause of symptoms related to degenerative spondylotic radiculopathy. The treatment is spinal stabilization. No direct bone or soft tissue decompression is necessary.Copyright © 2018 Elsevier Inc. All rights reserved.

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