Comparison between transuncal approach and upper vertebral transcorporeal approach for unilateral cervical radiculopathy - a preliminary report.

摘要

OBJECTIVE: The surgical treatments for unilateral cervical radiculopathy have been performed by either the anterior or posterior approach. The anterior approach has usually been used more than the posterior approach. The authors compared the results of newly advanced upper vertebral transcorporeal (UVTC) approach with those of the original transuncal (TU) approach in the anterior approach. METHODS: The anterior cervical microforaminotomy was performed for 60 patients (male:female=40:20) from June, 2000 to October, 2003. 40 patients were treated by the TU approach while 20 patients were operated on by the new UVTC approach. The authors analyzed postoperative changes of disc height, the spinal instability, the average length of hospital stay, the degree of patients' satisfaction and complications from each approach. The mean follow-up period was 9.5 months. RESULTS: In the TU approach, postoperative intervertebral disc height was decreased from 7.1+/-0.65 mm to 6.2+/-0.61 mm. In the UVTC approach, postoperative intervertebral disc height was decreased from 6.6+/-0.43 mm to 6.3+/-0.41 mm. The average length of hospital stay was 5.2 days for the TU approach and 3.4 days for the UVTC approach. In the TU approach, 28 patients experienced excellent results, 11 patients experienced good results, one patient who experienced a fair result was operated by anterior cervical fusion because of a recurrent herniated disc. In the UVTC approach, 16 patients had excellent results and four patients experienced good results. CONCLUSIONS: This comparative study demonstrates that the UVTC approach is a better surgical technique than the TU approach considering the preservation of disc height, spinal stability, length of hospital stay, degree of satisfaction and complications.