Surgical Procedure Selection for Cervical Radiculopathy―Morphological Insights from Height of the Superior Articular Process in the Intervertebral Foramen―

In recent years, advances in imaging diagnostics and increased clinical awareness have led to a rise in the diagnosis of cervical radiculopathy, making it a relatively common condition. Initial treatment typically began with segmental diagnosis based on neurological examination. Cervical radiculopathy can often be treated conservatively; however, early surgical intervention may be necessary in patients presenting with severe symptoms. Accurate diagnosis and stable surgical treatment enable early symptom relief, eliminating the need for conservative treatment. In addition to decompressing the nerve within the intervertebral foramen, a critical aspect of surgical treatment of cervical radiculopathy involves minimizing the effects of segmental instability. In this study, we retrospectively reviewed the surgical cases of cervical radiculopathy treated at our hospital, focusing on the height of the superior articular process (SAP), which forms the posterior structure of the intervertebral foramen. We hypothesized that a higher SAP and lower pedicle-SAP (P-SAP) value may reduce the effects of segmental instability on the nerve root and could potentially lower the incidence of postoperative complications such as subsidence and loss of disc height. Based on these considerations, patients with a high SAP and low P-SAP value may be more suitable candidates for an anterior surgical approach.