Clinical outcomes of microendoscopic foraminotomy and decompression in the cervical spine

Objective: Few reports have addressed long-term outcomes, as well as the safety and efficacy of the cervical microendoscopic foraminotomy (CMEF) and cervical microendoscopic diskectomy (CMED) procedures used in modern spine practice to treat degenerative disease of the cervical spine. Accordingly, we present long-term outcomes from a cohort of patients treated for foraminal stenosis or disk herniation with the CMEF or CMED procedure, respectively. Methods: A total of 38 patients were included in the study, with a mean follow-up of 24.47 ± 12.84 months. Patients were monitored prospectively with questionnaires consisting of a visual analog scale for the neck (VASN) and arm (VASA), and a neck disability index (NDI) form. Operative time, estimated blood loss, and hospitalization stay also were collected. Data were analyzed with Microsoft Office Excel 2007. Results: The mean 1 year follow-up scores all showed statistically significant improvements: NDI (P = 0.0019), VASN (P = 0.0017), VASA (P ≤ 0.0001). Similar results were seen at 2-year follow-up: NDI (P = 0.0011), VASN (P = 0.0022), and VASA (P ≤ 0.0001); and at 3- to 6-year follow-up: NDI (P = 0.0015), VASN (P = 0.0200), and VASA (P = 0.0034). The average operation time, hospitalization stay, and estimated blood loss were 154.27 ± 26.79 minutes, 21.22 ± 14.23 hours, and 27.92 mL, respectively. There were no statistically significant differences when patients were compared by age (over 50 vs. under 50), operative level (above C6 vs. below C6), or sex. One complication was reported in this study consisting of duratomy, which required no further intervention. Conclusion: Posterior CMEF and CMED are safe and effective procedures for minimally invasive decompression in the cervical spine.