A review of laminoforaminotomy for the management of lateral and foraminal cervical disc herniations or spurs

BACKGROUND Anterior versus posterior surgical management of lateral and foraminal cervical disc disease remains controversial. The key hole foraminotomy or laminoforaminotomy allows dorsal resection without the instability encountered with anterior cervical approaches, with more limited morbidity. Unilateral radiculopathy can be addressed with the laminoforaminotomy, while bilateral or multifocal radiculopathy with myelopathy may additionally require a laminectomy or laminoplasty. METHODS Selection of patients for laminoforaminotomy should be based upon correlation of clinical findings and neurodiagnostic (MR, CT) studies to ensure that the dorsal approaches will sufficiently address the pathology. RESULTS The technical completion of a laminoforaminotomy is reviewed. CONCLUSIONS Performing adequate preoperative MR and CT examinations allows for the selection of patients who will benefit from the "key hole" or "laminoforaminotomy" approaches to lateral and foraminal disc disease and/or spur formation. (C) 2002 by Elsevier Science Inc.