Minimally Invasive Laminoforaminotomy for Cervical Foraminal Narrowing Using Tubular Retractor System - A Prospective Study

Abstract Background: A minimally invasive approach to spinal pathology has significantly progressed in the past few years. Laminoforaminotomy using a tubular retractor system directly removes compressive pathology while maximally preserving segmental motion. Objective: Our study aimed to evaluate the outcome in patients undergoing microscopic posterior cervical foraminotomy for single-level cervical disease using a tubular retractor system. Material and Methods: All patients presenting with cervical radicular pain not responding to conservative management for 6 weeks were screened with magnetic resonance imaging of the cervical spine. Patients with refractory pain were subjected to minimally invasive discectomy using a tubular retractor system by posterior approach. Postoperative patients were followed with a visual analog scale (VAS) and 36-item Short Form Health Survey (SF-36). Results: A total of 13 patients were included in the study. 25%–30% of the facet was resected for foraminotomy. The mean VAS score for radicular pain was nine preoperatively, which improved postsurgery, at 6 months follow-up, the radiculopathy was 0.54 ± 0.52 with P < 0.001. In all eight domains of SF-36 data, statistically significant improvement was noted. Among the variables of SF-36, it has been reported that there was a significant improvement in the emotional component after surgery. Conclusion: The minimally invasive posterior approach using a tubular retractor system minimizes paraspinal muscle injury, reducing postoperative neck discomfort with no operative site infection. Minimal facet capsule dissection and facet drilling help in early recovery and less postoperative morbidity.