Intervertebral Foramen Width Is an Important Factor in Deciding Additional Uncinate Process Resection in ACDF—a Retrospective Study

Background: Anterior cervical discectomy and fusion (ACDF) has been established as a classic procedure for the management of cervical radiculopathy. However, it is unclear whether combined uncinate process resection (UPR) is necessary for treating cervical radiculopathy. Here, we investigated the cl...

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Autores principales:	Baifeng Sun, Chen Xu, Yizhi Zhang, Shenshen Wu, Huiqiao Wu, Hao Zhang, Xiaolong Shen, Zifan Zhang, Wen Yuan, Yang Liu
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	uncovertebral joint anterior cervical discectomy and fusion uncinate process resection cervical radiculopathy intervertebral foramen decompression Surgery RD1-811
Acceso en línea:	https://doaj.org/article/7123b15e37724286a842d80b837ab177
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spelling	oai:doaj.org-article:7123b15e37724286a842d80b837ab1772021-11-19T04:35:32ZIntervertebral Foramen Width Is an Important Factor in Deciding Additional Uncinate Process Resection in ACDF—a Retrospective Study2296-875X10.3389/fsurg.2021.626344https://doaj.org/article/7123b15e37724286a842d80b837ab1772021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fsurg.2021.626344/fullhttps://doaj.org/toc/2296-875XBackground: Anterior cervical discectomy and fusion (ACDF) has been established as a classic procedure for the management of cervical radiculopathy. However, it is unclear whether combined uncinate process resection (UPR) is necessary for treating cervical radiculopathy. Here, we investigated the clinical outcome of ACDF combined with UPR compared to ACDF alone to determine the necessity of UPR in treating cervical radiculopathy.Hypothesis: Uncinate process resection may be necessary in certain patients along with ACDF to achieve better clinical outcomes of cervical radiculopathy.Patients and Methods: Fifty-five patients underwent ACDF with UPR, and 126 patients without UPR were reviewed. The width and height of the intervertebral foramen were measured by 45° oblique X-rays. We also measured the Japanese Orthopedic Association (JOA) score and visual analog scale (VAS) score. C2–C7 Cobb angles were obtained from all patients pre- and post-operatively. Meanwhile, linear regression analysis was used to evaluate the relationship between the clinical outcomes and the intervertebral foramen width before surgery.Results: Linear regression analysis indicated that the improvement in the JOA and VAS scores was irrelevant to both the pre-operative width of the intervertebral foramen (wIVF) and the height of the intervertebral foramen (hIVF) in the ACDF+UPR group. However, pre-operative wIVF was associated with post-operative JOA and VAS scores in the ACDF alone group. Those with pre-operative wIVF <3 mm in the ACDF group had the least improvement in post-operative clinical symptoms due to the change in wIVF (P > 0.05). The ACDF group whose wIVF was over 3 mm showed similar clinical outcomes to the ACDF + UPR group, and wIVF significantly increased post-operatively (P < 0.05). The fusion rate and C2–C7 Cobb angles did not show significant differences between the two groups (P > 0.05).Discussion: Our current findings suggest that UPR should be considered when wIVF is <3 mm pre-operatively. However, there is no need to sacrifice the uncovertebral joint in ACDF when the pre-operative wIVF is over 3 mm.Level of Evidence: Level III.Baifeng SunChen XuYizhi ZhangShenshen WuShenshen WuHuiqiao WuHao ZhangXiaolong ShenZifan ZhangWen YuanYang LiuFrontiers Media S.A.articleuncovertebral jointanterior cervical discectomy and fusionuncinate process resectioncervical radiculopathyintervertebral foramen decompressionSurgeryRD1-811ENFrontiers in Surgery, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	uncovertebral joint anterior cervical discectomy and fusion uncinate process resection cervical radiculopathy intervertebral foramen decompression Surgery RD1-811
spellingShingle	uncovertebral joint anterior cervical discectomy and fusion uncinate process resection cervical radiculopathy intervertebral foramen decompression Surgery RD1-811 Baifeng Sun Chen Xu Yizhi Zhang Shenshen Wu Shenshen Wu Huiqiao Wu Hao Zhang Xiaolong Shen Zifan Zhang Wen Yuan Yang Liu Intervertebral Foramen Width Is an Important Factor in Deciding Additional Uncinate Process Resection in ACDF—a Retrospective Study
description	Background: Anterior cervical discectomy and fusion (ACDF) has been established as a classic procedure for the management of cervical radiculopathy. However, it is unclear whether combined uncinate process resection (UPR) is necessary for treating cervical radiculopathy. Here, we investigated the clinical outcome of ACDF combined with UPR compared to ACDF alone to determine the necessity of UPR in treating cervical radiculopathy.Hypothesis: Uncinate process resection may be necessary in certain patients along with ACDF to achieve better clinical outcomes of cervical radiculopathy.Patients and Methods: Fifty-five patients underwent ACDF with UPR, and 126 patients without UPR were reviewed. The width and height of the intervertebral foramen were measured by 45° oblique X-rays. We also measured the Japanese Orthopedic Association (JOA) score and visual analog scale (VAS) score. C2–C7 Cobb angles were obtained from all patients pre- and post-operatively. Meanwhile, linear regression analysis was used to evaluate the relationship between the clinical outcomes and the intervertebral foramen width before surgery.Results: Linear regression analysis indicated that the improvement in the JOA and VAS scores was irrelevant to both the pre-operative width of the intervertebral foramen (wIVF) and the height of the intervertebral foramen (hIVF) in the ACDF+UPR group. However, pre-operative wIVF was associated with post-operative JOA and VAS scores in the ACDF alone group. Those with pre-operative wIVF <3 mm in the ACDF group had the least improvement in post-operative clinical symptoms due to the change in wIVF (P > 0.05). The ACDF group whose wIVF was over 3 mm showed similar clinical outcomes to the ACDF + UPR group, and wIVF significantly increased post-operatively (P < 0.05). The fusion rate and C2–C7 Cobb angles did not show significant differences between the two groups (P > 0.05).Discussion: Our current findings suggest that UPR should be considered when wIVF is <3 mm pre-operatively. However, there is no need to sacrifice the uncovertebral joint in ACDF when the pre-operative wIVF is over 3 mm.Level of Evidence: Level III.
format	article
author	Baifeng Sun Chen Xu Yizhi Zhang Shenshen Wu Shenshen Wu Huiqiao Wu Hao Zhang Xiaolong Shen Zifan Zhang Wen Yuan Yang Liu
author_facet	Baifeng Sun Chen Xu Yizhi Zhang Shenshen Wu Shenshen Wu Huiqiao Wu Hao Zhang Xiaolong Shen Zifan Zhang Wen Yuan Yang Liu
author_sort	Baifeng Sun
title	Intervertebral Foramen Width Is an Important Factor in Deciding Additional Uncinate Process Resection in ACDF—a Retrospective Study
title_short	Intervertebral Foramen Width Is an Important Factor in Deciding Additional Uncinate Process Resection in ACDF—a Retrospective Study
title_full	Intervertebral Foramen Width Is an Important Factor in Deciding Additional Uncinate Process Resection in ACDF—a Retrospective Study
title_fullStr	Intervertebral Foramen Width Is an Important Factor in Deciding Additional Uncinate Process Resection in ACDF—a Retrospective Study
title_full_unstemmed	Intervertebral Foramen Width Is an Important Factor in Deciding Additional Uncinate Process Resection in ACDF—a Retrospective Study
title_sort	intervertebral foramen width is an important factor in deciding additional uncinate process resection in acdf—a retrospective study
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/7123b15e37724286a842d80b837ab177
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Intervertebral Foramen Width Is an Important Factor in Deciding Additional Uncinate Process Resection in ACDF—a Retrospective Study

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