You are fortunate to be living in a period of time when the concepts of traditional spine surgery are dramatically changing. Improvements in anesthesia and technological advancements in surgical techniques and equipment continue to reveal efficient new ways to perform spine surgery safely. Minimally invasive spine procedures are making it possible for patients to go home the day of or the day after surgery. These specialized procedures use tiny surgical instruments and small incisions, which affords patients speedier recoveries, fewer complications and less scarring. The purpose of this article is to introduce you to the study results from an outpatient surgical procedure used to treat Cervical Radiculopathy. However, before proceeding, you need to know what cervical radiculopathy means. Cervical radiculopathy means a spinal nerve root in the neck is irritated or compressed. The spinal nerve roots are located in the spinal canal and the neuroforamen. The neuroforamen are small holes through which the spinal nerves exit the spinal column. Outside the spine these nerves branch off into other parts of the body forming the peripheral nervous system. Nerve irritation may result from disc herniation, spinal stenosis, osteophyte formation or other degenerative disorders. Nerve irritation may cause sensory and motor abnormalities called neurologic deficit. Pain, tingling and numbness are examples of a sensory abnormality. Weakness and reflex loss are examples of a motor abnormality.

Cervical radiculopathy may cause symptoms to appear in the neck, shoulders, arms, hands and fingers. An MRI or myelography and CT scan may follow a physical examination and neurological evaluation. These tests help the spine specialist determine where the radiculopathy is located and if the patient’s symptoms

correlate to the image studies. Depending on the cause of the cervical radiculopathy, the spine specialist may first recommend non-surgical treatment. This treatment may include medication and physical therapy. Of course, not all patients are alike and some patients may require surgery. The study involved 500 patients with cervical radiculopathy. Two hundred of these patients opted for outpatient spine surgery. The ‘outpatient’ operations were performed using general anesthesia, a posterior approach, limited tissue dissection and laminoforaminotomy at each affected level of the spine. A laminoforaminotomy is a procedure where the lamina, bony area covering posterior access to the neuroforamen is removed, which gives the surgeon access to the affected nerve roots. During this procedure, the nerve roots are decompressed. Following surgery, each patient was observed for several hours and discharged when able to meet physical criteria such as walking without assistance. No patient required hospital admission in the post-operative period. Out of the 200 patients, 180 patients followed-up for an average of 19 months. Although all patients with cervical radiculopathy are not candidates for outpatient surgery, the study results are very encouraging. The absence of post-operative infection and complications combined with successful long-term outcomes shed a bright light on the future of these procedures.