Big Data on Posterior Foraminotomy or ACDF for Single-level Compression

Just enough in a recent study to tip us to ACDF if it's a close call

What’s the Claim?

A large-database study suitable to the task at hand found that among patients with single-level cervical root compression (and without myelopathy):

  • Anterior cervical discectomy and fusion (ACDF) had much lower odds of several major complications — surgical site infection (adjusted odds ratio 3.7 [2.7-4.9]) being especially notable — within 90 days of surgery than did patients who had posterior cervical foraminotomy (PCF)
  • PCF, not surprisingly, avoided dysphagia along with a few other minor complications, but was associated with a much higher odds of wound dehiscence (OR 5.9 [3.9-8.8])
  • ACDF beat PCF in five-year revision rates (14.8% versus 19%), despite, presumably, some patients developing adjacent-segment problems after ACDF

How’s It Stack Up?