Full Endoscopic Key Hole Technique for Cervical Foraminal Stenosis: Is Mere Dorsal Decompression Enough?

OBJECTIVE: To study whether and when mere dorsal decompression is enough in the full endoscopic key hole technique for foraminal stenosis. METHODS: We retrospectively reviewed a total of 22 patients with cervical foraminal stenosis who underwent full endoscopic key hole mere dorsal decompression in our institute from October 2016 to October 2017. RESULTS: Preoperative neck disability index, neck visual analog scale score, and arm visual analog scale score were 25.8 +/- 0.8, 4.9 +/- 0.6, and 7.5 +/- 0.5 in the group. Immediate postoperative scores were 6.9 +/- 0.9, 1.3 +/- 0.9, and 1.4 +/- 0.5. Follow-up scores at 3 months (7.0 +/- 0.9, 1.9 +/- 0.6, and 2.7 +/- 0.9), 6 months (7.3 +/- 0.9, 2.1 +/- 0.9, and 1.9 +/- 0.5), and 12 months (7.6 +/- 0.5, 2.5 +/- 0.8, and 2.1 +/- 0.7). The symptoms had improved significantly (P < 0.05). According to the Macnab criteria, 15 patients reported excellent results, 2 reported good results, and 2 reported fair results at the 12-month follow-up. CONCLUSIONS: Stenosis is mainly caused by dorsal structures; mere dorsal decompression is enough. In both cases, the ventral and dorsal structures contributed to the stenosis. When there is no herniated soft fragment contributing to the stenosis, ventral decompression is not always necessary. If intraoperative exploration detects less tension formed by the ventral abnormal structures, mere dorsal decompression is enough to settle the symptoms.