Safety and efficacy of direct nerve root decompression via anterior cervical discectomy and fusion with uncinectomy for cervical radiculopathy

Cervical radiculopathy is a common spinal condition associated with pain, sensory disturbances, and motor weakness. Symptoms often can be attributable to either disc herniation and/or bony foraminal stenosis due to uncinate hypertrophy. Posterior cervical foraminotomy and conventional anterior cervical discectomy and fusion (ACDF) represent the mainstay of treatment. In patients with severe bony foraminal stenosis, posterior foraminotomy and standard ACDF without complete resection of uncinate process may result in incomplete decompression. ACDF with uncinectomy allows for complete and direct decompression of the exiting nerve root, and may lead to improved clinical outcome in appropriately selected patients. We describe the technique for ACDF with uncinectomy and report the clinical outcome in a consecutive series of patients.