The Measurements Of Intervertebral Foraminal Area And Angulation Of Cervical Vertebra Before And After Anterior Cervical Discectomy

Aim: There are two main problems after cervical discectomy without using bone graft or methalic instruments; angulation and foraminal stenosis. We evaluated these problems which occur after cervical discectomy.
Methods: We viewed the control magnetic resonance images (MRI) of 13 patients who had been operated with simple anterior cervical discectomy, regarding the fact that at least one year had passed after operation. We measured the right and left side foraminal areas on the sagittal section of MRI. We also studied how the foraminal areas were affected from the postoperative angulation on the cervical vertebra.
Results: In cases, where the intervertebral disc space had narrowed after the anterior cervical discectomy and where there was no appearance of forward angulation, the right and left side measurements revealed significant decrease (P≤0.05) (Wilcoxon) for the measurement of foraminal areas (patients 1-8). Clinically, all 8 cases had root irritation findings. Besides this situation, in the cases who had 100 or more forward angulation after the operation, there were significant increase (P≤0.05) (Wilcoxon) for the measurement of foraminal areas (patients 9-13). Clinically, these patients had muscular tension type headaches.
Conclusion: It is well known that cervical spine arrangement is destroyed due to angulation and this causes chronic neck pains in the postoperative period. Despite this chronic pains, angulation is still a benefitial development for the patient because of the enlargement of the foraminal area. Although angulation is not an acceptable situtation for the arrangement of the spine, it may be preferable result when prognosis is concerned.

Keywords
Angulation, anterior cervical discectomy, intervertebral foraminal area