Cervical disc replacement vs. MIS cervical foraminotomy: Which is better?

Cervical disc replacement may have advantages over minimally invasive posterior cervical foraminotomy to treat cervical radiculopathy, according to a study published in the May 2024 issue of The Spine Journal.

The study included 152 patients who had surgery for cervical radiculopathy at one institution between 2012 and 2020. Eighty-six had cervical disc replacement and 66 had minimally invasive posterior cervical foraminotomy. They had follow-ups for at least 24 months.

The disc replacement group had longer mean operating time but comparable blood loss and length of stay to cervical foraminotomy, researchers found. The disc replacement group had greater complication rates but that was primarily driven by approach-related dysphagia in most patients.

The cervical foraminotomy group had greater revision rates, while the disc replacement group had significantly greater improvements in Neck Disability Index scores at the last follow-up.

The study concluded that “results suggest that [cervical disc replacement offers] clinically relevant advantages over MI-PCF in terms of long-term revision rates despite an increased approach-related risk of transient postoperative dysphagia. Additionally, patients in the ACDR cohort achieved greater mean improvements in NDI scores but these results may have limited clinical significance due to inability to reach minimally clinically important difference thresholds.”