Mini Open Foraminotomy (MOF) for Cervical Radiculopathy: Technical Note

Background: Favorable surgical results had been reported in cervical posterior foraminotomy using endoscopy; however, the learning curve for the surgeon is steep. We therefore developed a procedure that can be performed more easily and with small incision, called “Mini Open Foraminotomy (MOF)”, using a tubular retractor (22mm diameter) under direct vision. The purpose of this study was to demonstrate the surgical procedure about MOF for cervical radiculopathy and assess a postoperative result of MOF. Materials/Methods: We performed MOF on 19 consecutive patients (15 males and 4 females) with cervical radiculopathy. Average age at time of operation was 48.9 years. Average follow-up period was 30.6 months. Spondylotic radiculopathy was diagnosed in 12 cases and disc herniation in seven cases. Skin incision was approximately 3 cm. Large (22mm diameter) METRx tube with illumination was fixed into paravertebral muscle. The lower articular process of the upper vertebra and the upper articular process of the lower vertebra were shaved with pneumatic drill and Kerrison rongeur to decompress the nerve root under direct vision. Results: Mean operation time was 78±26 minutes. Mean hemorrhage weight was 50±46ml. All patients were able to stand and walk without neck collars on the first postoperative day, with dramatic reduction of radicular pain. Mean VAS of radicular pain showed significant improvement at final follow up compared with that before surgery (0.5±1.1 and 7.1±2.6, respectively; p<0.0001). Conclusions: Mini open foraminotomy is a less invasive, more easily, and safe procedure, moreover effective surgical option for the management of cervical radiculopathy.