Acdf vs foraminotomy

EBSSalem Al-Dwairy

Spine fellow: Macquarie Neurosurgery.Macquarie university.

December, 2015

• 55years old.• Neck pain + severe left arm pain

for three months.• Not responding to conservative

treatment.

foraminotomy vs ACDF

PICO: In patients with cervical radiculopathy does ACDF or foraminotomy lead to better resolution of arm pain and the need for further surgery?

• P: Patients with cervical radiculopathy.• I: Cervical fusion.• C: Foraminotomy• O: resolution of radicular pain, redo surgery.

Data bases:• Medline.• Embase.• Scopus.

MedlineACDF

Foraminotomy

Embase

ACDF

Foraminotomy

Medline186

Scopus84

Embase204

52

26

15

Medline 286 Embase 204 Scopus 84

574

Duplicates 72

Total 16 (7 included, 1 local Egyptian journal, 1study protocol, 3 cost effectiveness)

387

After reviewing titles: 505 excluded,Posterior cervical fusion, surgery for C myelopathy, anterior C foraminotomy, laminoplasty,ASD, surgical techniques,case reports,…..

69

Reviewing abstracts

12

4 papers added from references

Conclusion • Foraminotomy has comparable results as ACDF in relieving pain.• ? Both has similar reoperation rate at the index level.• ? ACDF might have more rapid relief in symptoms and/or motor

weakness while in hospital stay.