Acdf vs foraminotomy

1. EBS
Salem Al-Dwairy
Spine fellow: Macquarie
Neurosurgery.
Macquarie university.
December, 2015

2. • 55years old.
• Neck pain + severe left arm pain
for three months.
• Not responding to conservative
treatment.
foraminotomy vs ACDF

3. 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.

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

5. Medline
ACDF
Foraminotomy

8. Embase
ACDF
Foraminotomy

10. Medline
186
Scopus
84
Embase
204
52
26
15

11. 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

12. 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.