A comprehensive study on cervical foraminal stenosis severity: clinical implications and postoperative outcomes

Abstract

Aim: To assess the clinical implications of cervical foraminal stenosis severity and evaluate the impact of surgical intervention on postoperative outcomes. Methods: A retrospective analysis was conducted on 557 patients who underwent anterior cervical discectomy and fusion (ACDF) surgery for cervical disc herniation between 2020 and 2023. Cervical foraminal stenosis severity was graded using a classification system based on axial T2-weighted magnetic resonance imaging (MRI) images. Preoperative and postoperative visual analog scale (VAS) and Neck Disability Index (NDI) scores were recorded to evaluate pain and disability levels. Results: The majority of patients (79.5%) exhibited severe stenosis (grade 2), with significant improvements in VAS and NDI scores observed postoperatively. Patients with grade 2 stenosis demonstrated the most pronounced reduction in VAS scores, indicating greater pain relief following surgery. However, patients with grade 0 and grade 1 stenosis also experienced improvements in pain and disability scores postoperatively. Conclusions: Cervical foraminal stenosis severity significantly influences postoperative outcomes, with surgical intervention leading to substantial improvements in pain and disability levels, particularly in cases of severe stenosis. These findings underscore the importance of accurately grading stenosis severity and considering surgical intervention as an effective treatment option for symptomatic patients.