Microcervical foraminotomy. A surgical alternative for intractable radicular pain.

Utilizing a microsurgical technique that minimizes laminectomy and facet trauma, simple posterior foraminotomy has been used for the treatment of intractable radicular pain in 235 patients with 585 symptomatic cervical nerve roots during the past ten years. The procedure was initially applied as an alternative treatment for patients unresponsive to anterior discectomy and/or laminectomy procedures. The operation accomplishes a thorough decompression of the posterior and inferior walls of the foraminal tube from entrance to exit, without disturbance of the intervertebral disc. All patients in the series experienced resolution of radicular pain by this technique. Correlation between preoperative myelographic defects and surgical pathology became less rewarding as the series matured since the majority of foraminal lesions apparently responsible for root irritation lie outside the spinal canal.