PT  - JOURNAL ARTICLE
AU  - Santangelo, Gabrielle
AU  - Wathen, Connor
AU  - Macaluso, Dominick
AU  - Dagli, Mert Marcel
AU  - Ali, Zarina S.
AU  - Malhotra, Neil R.
AU  - Casper, David S.
AU  - Spadola, Michael
AU  - Ghenbot, Yohannes
AU  - Thakkar, Khush
AU  - Maze, Gabriella
AU  - Welch, William C.
AU  - Ozturk, Ali K.
TI  - Comparison of Single-Level Posterior Cervical Foraminotomy to Anterior Cervical Discectomy and Fusion for Radiculopathy
AID  - 10.14444/8447
DP  - 2023 Jun 01
TA  - International Journal of Spine Surgery
PG  - 418--425
VI  - 17
IP  - 3
4099  - https://www.ijssurgery.com/content/17/3/418.short
4100  - https://www.ijssurgery.com/content/17/3/418.full
SO  - Int J Spine Surg2023 Jun 01; 17
AB  - Background Posterior cervical foraminotomy (PCF) and anterior cervical discectomy and fusion (ACDF) are 2 commonly used surgical approaches to address cervical radiculopathy. Demonstrating superiority in clinical outcomes and durability of one of the approaches could change clinical practice on a large scale. This is the largest reported single-institutional retrospective cohort of single-level PCFs compared with single-level ACDFs for cervical radiculopathy.Methods Patients undergoing either ACDF or PCF between 2014 and 2021 were identified using Current Procedural Terminology codes. Medical records were reviewed for demographics, surgical characteristics, and reoperations. Statistical analysis included t tests for continuous characteristics and c2 testing for categorical characteristics.Results In total, 236 single-level ACDFs and 138 single-level PCFs were included. There was no significant difference in age (51.0 vs 51.3 years), body mass index (BMI; 28.6 vs 28.1), or Charlson Comorbidity Index (1.89 vs 1.68) between patients who underwent ACDF and those who underwent PCF. There was no difference in the rate of reoperation (5.1% vs 5.1%), time to reoperation (247 vs 319 days), or reoperation for recurrent symptoms (1.7% vs 2.9%) for ACDF vs PCF. Hospital length of stay (LOS) was longer for ACDF compared with PCF (1.65 vs 1.35 days, P = 0.041), and the overall readmission rate after ACDF was 20.8% vs 10.9% after PCF (P = 0.014).Conclusions Overall reoperation rates or reoperation for recurrent symptoms between ACDF and PCF were not significantly different, demonstrating that either procedure effectively addresses the indication for surgery. There was a significantly longer LOS after ACDF than PCF, and readmission rates at 90 days and 1 year were higher after ACDF.Level of Evidence 3.