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ORIGINAL ARTICLE
Year : 2015  |  Volume : 2  |  Issue : 1  |  Page : 8-12

Posterior cervical laminoforaminotomy: A comparative study between open vs minimally invasive approach


1 Postgraduate, Department of Neurosurgery, MS Ramaiah Medical College, Bengaluru, Karnataka, India
2 Associate Professor, Department of Neurosurgery, MS Ramaiah Institute of Neurosciences, Bengaluru, Karnataka, India
3 Assistant Professor, Department of Neurosurgery, MS Ramaiah Institute of Neurosciences, Bengaluru, Karnataka, India
4 Professor and Head, Department of Neurosurgery, MS Ramaiah Institute of Neurosciences, Bengaluru, Karnataka, India
5 Senior Professor, Department of Neurosurgery, MS Ramaiah Institute of Neurosciences, Bengaluru, Karnataka, India

Correspondence Address:
Umesh Srikantha
Associate Professor, Department of Neurosurgery, MS Ramaiah Institute of Neurosciences, Bengaluru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.5005/jp-journals-10039-1046

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Objectives: Minimally invasive spine surgery is gradually being preferred over conventional techniques due to several advantages. Our study was conducted to compare the persistent cervical symptoms and the surgical outcomes between open cervical laminoforaminotomy (O-CLF) and minimally invasive cervical laminoforaminotomy (MI-CLF). Materials and methods: Between June 2011 and 2013, 14 patients with radicular pain in the upper limb with magnetic resonance imaging (MRI) proven posterolateral cervical disk prolapse and failed conservative treatment were assigned to either O-CLF or MI-CLF. Neurological examination and visual analog scale (VAS) for upper limb and neck pain was done. Follow-up was done on day 1, 4 weeks and 6 months. Results: Out of the 14 patients, seven underwent O-CLF and seven underwent MI-CLF. Demographic characteristics and operating time were comparable between the two groups. The mean follow-up duration was 3 months. Mean blood loss was higher in O-CLF group (150 ml) as compared to MI-CLF (30 ml). Postoperative analgesic requirement was also significantly high in the O-CLF group. Length of hospital stay was more in the O-CLF (4.85 days) as against MI-CLF (1.28 days). Visual analog scale scores for radicular pain did not differ between the two groups. However, VAS scores for neck pain was significantly higher in O-CLF at 6 weeks follow-up as compared to the MI-CLF group. Patients who underwent MI-CLF returned to work faster (2.28 weeks) than their O-CLF counterparts (3.42 weeks). Conclusion: Minimally invasive cervical laminoforaminotomy results in reduction of postoperative analgesic requirements, hospital stay, blood loss, decreased incidence of postoperative axial neck pain and early return to work.


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