{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T08:43:12Z","timestamp":1780389792913,"version":"3.54.1"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,11,8]],"date-time":"2021-11-08T00:00:00Z","timestamp":1636329600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81830077"],"award-info":[{"award-number":["81830077"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the outcomes of cervical spondylotic radiculopathy secondary to bony foraminal stenosis treated with anterior cervical discectomy and fusion (ACDF) combined with anterior cervical foraminotomy (ACF) assisted by High\u2010Definition 3\u2010Dimensional Exoscope.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective study, a total of 19 consecutive patients (12 males and seven females, with an average of 49.2\u2009years, range from 40 to 59\u2009years) with spondylotic radiculopathy caused by bony foraminal stenosis underwent ACDF combined with ACF assisted by High\u2010Definition 3\u2010Dimensional Exoscope in our hospital between January 2019 and December 2019 were included in this study. All patients signed the consent form before the surgery. The patient baseline information such as gender, age, body mass index (BMI), surgery time, blood loss, hospital stay, lesion segment, side, follow\u2010up time and postoperative complications were recorded. The Japanese Orthopedic Association (JOA), Neck Disability Index (NDI), and Visual Analogue Scale (VAS) were measured and compared before surgery, 1\u2009months and final follow\u2010up after surgery. The radiographic outcomes were evaluated using the C<jats:sub>2<\/jats:sub>\u2010C<jats:sub>7<\/jats:sub> angel, disc height, foraminal height, superior diagonal distance, inferior diagonal distance, and foraminal area.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The involved levels included C<jats:sub>4<\/jats:sub>\u2010C<jats:sub>5<\/jats:sub> (six cases), C<jats:sub>5<\/jats:sub>\u2010C<jats:sub>6<\/jats:sub> (10 cases), C<jats:sub>6<\/jats:sub>\u2010C<jats:sub>7<\/jats:sub> (three cases). The mean duration of the surgery, mean blood loss, mean hospital stay, and mean follow\u2010up were 100\u2009\u00b1\u200911.10\u2009min, 19.4\u2009\u00b1\u20097.05\u2009mL, 7.1\u2009\u00b1\u20090.99\u2009days, and 12.1\u2009\u00b1\u20092.25\u2009months, respectively. The average preoperative JOA score was 11.9\u2009\u00b1\u20091.31, then improved to 15.7\u2009\u00b1\u20090.73 (t\u00a0=\u00a0\u221213.45, <jats:italic>P<\/jats:italic>\u00a0&lt;\u20090.001) and 16.2\u2009\u00b1\u20090.74 (t\u00a0=\u00a0\u221214.39, <jats:italic>P<\/jats:italic>\u00a0&lt;\u20090.001) at 1\u2009month after operation and at last follow\u2010up, respectively. The average preoperative NDI score was 27.3\u2009\u00b1\u20093.36, then decreased to 5.1\u2009\u00b1\u20091.79 (t\u00a0=\u00a020.63, <jats:italic>P<\/jats:italic>\u00a0&lt;\u20090.001) and 4.5\u2009\u00b1\u20091.21 (t\u00a0=\u00a025.53, <jats:italic>P<\/jats:italic>\u00a0&lt;\u20090.001) 1\u2009month after operation and at last follow\u2010up, respectively. The average preoperative VAS score was 6.7\u2009\u00b1\u20090.93, then decreased to 2.4\u2009\u00b1\u20090.69 (t\u00a0=\u00a015.05, <jats:italic>P<\/jats:italic>\u00a0&lt;\u20090.001) and 1.9\u2009\u00b1\u20090.78 (t\u00a0=\u00a016.40, <jats:italic>P<\/jats:italic>\u00a0&lt;\u20090.001) 1\u2009month after operation and at last follow\u2010up, respectively. As compared with the condition before surgery, there was a significant improvement in the C<jats:sub>2<\/jats:sub>\u2010C<jats:sub>7<\/jats:sub> angel, disc height, foraminal height, and foraminal area (<jats:italic>P<\/jats:italic>\u00a0&lt;\u20090.05). None of the patients developed postoperative vascular injury, nerve injury, loosening and rupture of the internal fixation, displacement of interbody fusion cage, and pseudarthrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ACDF combined with ACF assisted by High\u2010Definition 3\u2010Dimensional Exoscope is effective and safe for the treatment of CSR caused by secondary to bony foraminal stenosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13040","type":"journal-article","created":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T04:54:47Z","timestamp":1636433687000},"page":"2318-2326","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Anterior Cervical Discectomy and Fusion Combined with Foraminotomy Assisted by <scp>High\u2010Definition 3\u2010Dimensional<\/scp> Exoscope in the Treatment of Cervical Spondylotic Radiculopathy Secondary to Bony Foraminal Stenosis"],"prefix":"10.1111","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9150-8253","authenticated-orcid":false,"given":"Lu Lu","family":"Bai","sequence":"first","affiliation":[{"name":"Department of Spine Surgery Honghui Hospital, Xi'an Jiaotong University  Xi'an China"},{"name":"Graduate School Xi'an Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen Tao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery Honghui Hospital, Xi'an Jiaotong University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian Feng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery Honghui Hospital, Xi'an Jiaotong University  Xi'an China"},{"name":"Graduate School Xi'an Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Peng","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery Honghui Hospital, Xi'an Jiaotong University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu Kai","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery Honghui Hospital, Xi'an Jiaotong University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ding Jun","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery Honghui Hospital, Xi'an Jiaotong University  Xi'an 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