{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T21:59:00Z","timestamp":1780955940727,"version":"3.54.1"},"reference-count":35,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,10,14]]},"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Cervical radiculopathy due to discogenic or spondylotic stenosis of the neuroforamen can be surgically treated by an anterior discectomy with fusion (ACDF) or a posterior foraminotomy (FOR). Most surgeons prefer ACDF, although there are indications that FOR is as effective as ACDF, has a lower complication rate and is less expensive. A head-to-head comparison of the 2 surgical techniques in a randomised controlled trial has not yet been performed. The study objectives of the Foraminotomy ACDF Cost-Effectiveness Trial (FACET) study are to compare clinical outcomes, complication rates and cost-effectiveness of FOR to ACDF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>The FACET study is a prospective randomised controlled trial conducted in 7 medical centres in the Netherlands. The follow-up period is 2\u2005years. The main inclusion criterion is a radiculopathy of the C4, C5, C6 or C7 nerve root, due to a single-level isolated cervical foraminal stenosis caused by a soft disc and\/or osteophytic component, requiring operative decompression. A sample size of 308 patients is required to test the hypothesis of clinical non-inferiority of FOR versus ACDF. Primary outcomes are: \u2018operative success\u2019, the measured decrease in radiculopathy assessed by the visual analogue scale and \u2018patient success\u2019, assessed by the modified Odom's criteria. Secondary outcomes are: Work Ability Index (single-item WAI), quality of life (EuroQol 5 Dimensions 5 level Survey, EQ-5D-5L), Neck Disability Index (NDI) and complications. An economic evaluation will assess cost-effectiveness. In addition, a budget impact analysis will be performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval was obtained from the Institutional Ethics Committee of the University Medical Center Groningen. Results of this study will be disseminated through national and international papers. The participants and relevant patient support groups will be informed about the results of the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.trialregister.nl\/trialreg\/admin\/rctview.asp?TC=5536\" ext-link-type=\"uri\">NTR5536<\/jats:ext-link>\n                      , pre-results.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-012829","type":"journal-article","created":{"date-parts":[[2017,1,5]],"date-time":"2017-01-05T21:25:29Z","timestamp":1483651529000},"page":"e012829","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Study protocol for a randomised controlled multicentre study: the Foraminotomy ACDF Cost-Effectiveness Trial (FACET) in patients with cervical radiculopathy"],"prefix":"10.1136","volume":"7","author":[{"given":"A E H","family":"Broekema","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J M A","family":"Kuijlen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands"},{"name":"University of Groningen, University Medical Center Groningen, Groningen Spine Center, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G A T","family":"Lesman-Leegte","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R H M A","family":"Bartels","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A D I","family":"van Asselt","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands"},{"name":"Department of Pharmacy, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P C A J","family":"Vroomen","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0814-5680","authenticated-orcid":false,"given":"J M C","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M F","family":"Reneman","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Soer","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen, Groningen Spine Center, Groningen, The Netherlands"},{"name":"Saxion University of Applied Sciences Enschede, Enschede, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R J M","family":"Groen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,1,5]]},"reference":[{"key":"2025121403132393000_7.1.e012829.1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/117.2.325"},{"key":"2025121403132393000_7.1.e012829.2","unstructured":"Nederlandse Vereniging voor Neurochirurgie. 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