Does residual foraminal stenosis at levels not covered by anterior cervical discectomy and fusion aggravate postoperative outcomes in cervical radiculopathy?
- Author:
Sehan PARK
1
;
Dong-Ho LEE
;
San KIM
;
Chang Ju HWANG
;
Jae Hwan CHO
Author Information
- Publication Type:Clinical Study
- From:Asian Spine Journal 2025;19(6):978-986
- CountryRepublic of Korea
- Language:English
-
Abstract:
Methods:This was a retrospective cohort study of 188 patients undergoing ACDF for degenerative cervical radiculopathy between 2014 and 2020. Patients were divided into two groups: those with all symptomatic levels decompressed (No-FS group, n=162) and those with untreated FS at levels not targeted in surgery (FS group, n=26). Postoperative outcomes, including neck pain, arm pain, and Neck Disability Index (NDI), were evaluated at 3 months and 2 years. Radiographic parameters and ASD incidence were also compared between groups.
Results:Both groups showed significant improvement in neck pain, arm pain, and NDI postoperatively, with no significant intergroup differences at 3 months and 2 years. C2–C7 lordosis and sagittal vertical axis showed similar improvement in both groups postoperatively. Rates of ASD and revision surgery did not differ significantly between No-FS and FS groups (5.6% vs. 7.7%, respectively; p=0.652). Logistic regression revealed no significant predictors of NDI improvement >50% among preoperative demographic or radiographic factors.
Conclusions:Untreated FS at levels outside the surgical target area did not adversely affect ACDF outcomes or increase ASD risk over a 2-year follow-up. These findings suggest that ACDF can be safely limited to levels directly associated with patient symptoms without compromising clinical outcomes, potentially reducing the surgical extent and associated risks.
