{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T18:11:09Z","timestamp":1788199869646,"version":"build-2803163510"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","license":[{"start":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T00:00:00Z","timestamp":1721779200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,9,18]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Posterior cervical foraminotomy (posterior surgery) is a valid alternative to anterior discectomy with fusion (anterior surgery) as a surgical treatment of cervical radiculopathy, but the quality of evidence has been limited. The purpose of this study was to compare the clinical outcome of these treatments after 2 years of follow-up. We hypothesized that posterior surgery would be noninferior to anterior surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This multicenter, randomized, noninferiority trial assessed patients with single-level cervical radiculopathy in 9 Dutch hospitals with a follow-up duration of 2 years. The primary outcomes measured reduction of cervical radicular pain and were the success ratio based on the Odom criteria, and arm pain and decrease in arm pain, evaluated with the visual analog scale, with a 10% noninferiority margin, which represents the maximum acceptable difference between the new treatment (posterior surgery) and the standard treatment (anterior surgery), beyond which the new treatment would be considered clinically unacceptable. The secondary outcomes were neck pain, Neck Disability Index, Work Ability Index, quality of life, complications (including reoperations), and treatment satisfaction. Generalized linear mixed effects modeling was used for analyses. The study was registered at the Overview of Medical Research in the Netherlands (OMON), formerly the Netherlands Trial Register (NTR5536).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>From January 2016 to May 2020, 265 patients were randomized (132 to the posterior surgery group and 133 to the anterior surgery group). Among these, 25 did not have the allocated intervention; 11 of these 25 patients had symptom improvement, and the rest of the patients did not have the intervention due to various reasons. At the 2-year follow-up, of 243 patients, primary outcome data were available for 236 patients (97%). Predicted proportions of a successful outcome were 0.81 after posterior surgery and 0.74 after anterior surgery (difference in rate, \u22120.06 [1-sided 95% confidence interval (CI), \u22120.02]), indicating the noninferiority of posterior surgery. The between-group difference in arm pain was \u22122.7 (1-sided 95% CI, 7.4) and the between-group difference in the decrease in arm pain was 1.5 (1-sided 95% CI, 8.2), both confirming the noninferiority of posterior surgery. The secondary outcomes demonstrated small between-group differences. Serious surgery-related adverse events occurred in 9 patients (8%) who underwent posterior surgery, including 9 reoperations, and 11 patients (9%) who underwent anterior surgery, including 7 reoperations (difference in reoperation rate, \u22120.02 [2-sided 95% CI, \u22120.09 to 0.05]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This trial demonstrated that, after a 2-year follow-up, posterior surgery was noninferior to anterior surgery with regard to the success rate and arm pain reduction in patients with cervical radiculopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level I<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.23.00775","type":"journal-article","created":{"date-parts":[[2024,7,24]],"date-time":"2024-07-24T14:26:52Z","timestamp":1721831212000},"page":"1653-1663","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":14,"title":["Posterior Cervical Foraminotomy Compared with Anterior Cervical Discectomy with Fusion for Cervical Radiculopathy"],"prefix":"10.2106","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6828-5116","authenticated-orcid":false,"given":"N\u00e1dia F.","family":"Sim\u00f5es de Souza","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2657-7540","authenticated-orcid":false,"given":"Anne E.H.","family":"Broekema","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4058-3437","authenticated-orcid":false,"given":"Michiel F.","family":"Reneman","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3080-3361","authenticated-orcid":false,"given":"Jan","family":"Koopmans","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Martini Hospital Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8187-6044","authenticated-orcid":false,"given":"Henk","family":"van Santbrink","sequence":"additional","affiliation":[{"name":"Care and Public Health Research Institute School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands"},{"name":"Department of Neurosurgery, Zuyderland Medical Center, Heerlen, The Netherlands"},{"name":"Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3568-4820","authenticated-orcid":false,"given":"Mark P.","family":"Arts","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical Center Haaglanden, The Hague, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bachtiar","family":"Burhani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Elisabeth Tweesteden Ziekenhuis, Tilburg, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8638-4660","authenticated-orcid":false,"given":"Ronald H.M.A.","family":"Bartels","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8086-9870","authenticated-orcid":false,"given":"Niels A.","family":"van der Gaag","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands"},{"name":"Department of Neurosurgery, Haga Teaching Hospital, The Hague, The Netherlands"},{"name":"Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7376-0451","authenticated-orcid":false,"given":"Martijn H.P.","family":"Verhagen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Northwest Clinics, Alkmaar, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9391-4597","authenticated-orcid":false,"given":"Katalin","family":"Tam\u00e1si","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands"},{"name":"Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0814-5680","authenticated-orcid":false,"given":"J. Marc C.","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3067-763X","authenticated-orcid":false,"given":"Rob J.M.","family":"Groen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4154-1711","authenticated-orcid":false,"given":"Remko","family":"Soer","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Groninger Pain Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands"},{"name":"mProve Hospitals, Zwolle, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos M.A.","family":"Kuijlen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the FACET investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,7,24]]},"reference":[{"issue":"Pt 2","key":"bib1-20250430","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1093\/brain\/117.2.325","article-title":"Epidemiology of cervical radiculopathy. A population-based study from Rochester, Minnesota, 1976 through 1990","volume":"117","author":"Radhakrishnan","year":"1994","journal-title":"Brain."},{"issue":"17","key":"bib3-20250430","doi-asserted-by":"crossref","first-page":"2030","DOI":"10.1097\/01.BRS.0000083325.27357.39","article-title":"Impact of neck and arm pain on overall health status","volume":"28","author":"Daffner","year":"2003","journal-title":"Spine (Phila Pa 1976)."},{"issue":"3","key":"bib4-20250430","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1007\/s12178-016-9349-4","article-title":"Cervical radiculopathy","volume":"9","author":"Iyer","year":"2016","journal-title":"Curr Rev Musculoskelet Med."},{"issue":"1","key":"bib5-20250430","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1186\/s13018-020-01723-5","article-title":"Anterior cervical discectomy and fusion versus posterior cervical foraminotomy for the treatment of single-level unilateral cervical radiculopathy: a meta-analysis","volume":"15","author":"Fang","year":"2020","journal-title":"J Orthop Surg Res."},{"issue":"4","key":"bib6-20250430","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/S0090-3019(00)00201-9","article-title":"Cervical discectomy. A prospective analysis of three operative techniques","volume":"53","author":"Wirth","year":"2000","journal-title":"Surg Neurol."},{"key":"bib7-20250430","doi-asserted-by":"crossref","first-page":"100930","DOI":"10.1016\/j.inat.2020.100930","article-title":"Anterior or posterior approach in the surgical treatment of cervical radiculopathy; neurosurgeons\u2019 preference in The Netherlands","volume":"23","author":"Broekema","year":"2021","journal-title":"Interdisciplinary Neurosurgery."},{"issue":"5","key":"bib8-20250430","doi-asserted-by":"crossref","first-page":"E241","DOI":"10.1097\/BSD.0000000000000796","article-title":"Evaluation of current trends in treatment of single-level cervical radiculopathy","volume":"32","author":"Mok","year":"2019","journal-title":"Clin Spine Surg."},{"issue":"1","key":"bib9-20250430","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1001\/jamaneurol.2022.4208","article-title":"Noninferiority of posterior cervical foraminotomy vs anterior cervical discectomy with fusion for procedural success and reduction in arm pain among patients with cervical radiculopathy at 1 year: the FACET randomized clinical trial","volume":"80","author":"Broekema","year":"2023","journal-title":"JAMA Neurol."},{"issue":"1","key":"bib10-20250430","doi-asserted-by":"crossref","first-page":"e012829","DOI":"10.1136\/bmjopen-2016-012829","article-title":"FACET study group investigators. Study protocol for a randomised controlled multicentre study: the Foraminotomy ACDF Cost-Effectiveness Trial (FACET) in patients with cervical radiculopathy","volume":"7","author":"Broekema","year":"2017","journal-title":"BMJ Open."},{"issue":"24","key":"bib11-20250430","doi-asserted-by":"crossref","first-page":"2594","DOI":"10.1001\/jama.2012.87802","article-title":"CONSORT Group. Reporting of noninferiority and equivalence randomized trials: extension of the CONSORT 2010 statement","volume":"308","author":"Piaggio","year":"2012","journal-title":"JAMA."},{"key":"bib12-20250430","doi-asserted-by":"crossref","first-page":"607","DOI":"10.2106\/00004623-195840030-00009","article-title":"The treatment of certain cervical-spine disorders by anterior","volume":"40","author":"Smith","year":"1958","journal-title":"J Bone Joint Surg Am."},{"issue":"7889","key":"bib13-20250430","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1016\/S0140-6736(74)90884-8","article-title":"Measurement of pain","volume":"2","author":"Huskisson","year":"1974","journal-title":"Lancet."},{"issue":"4","key":"bib14-20250430","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1093\/occmed\/52.4.177","article-title":"Test-retest reliability of the Work Ability Index questionnaire","volume":"52","author":"de Zwart","year":"2002","journal-title":"Occup Med (Lond)."},{"issue":"1","key":"bib15-20250430","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/s00586-011-1920-5","article-title":"Neck Pain and Disability Scale and Neck Disability Index: validity of Dutch language versions","volume":"21","author":"Jorritsma","year":"2012","journal-title":"Eur Spine J."},{"issue":"11","key":"bib16-20250430","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1016\/j.spinee.2012.10.030","article-title":"Clinimetric properties of the EuroQol-5D in patients with chronic low back pain","volume":"12","author":"Soer","year":"2012","journal-title":"Spine J."},{"issue":"4","key":"bib17-20250430","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1007\/s00586-022-07109-x","article-title":"Validation of the Work Ability Index-Single Item and the Pain Disability Index-Work Item in patients with chronic low back pain","volume":"31","author":"Boekel","year":"2022","journal-title":"Eur Spine J."},{"issue":"1","key":"bib18-20250430","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1159\/000351887","article-title":"Long-term results of anterior versus posterior operations for herniated cervical discs: analysis of 6,000 patients","volume":"23","author":"Dohrmann","year":"2014","journal-title":"Med Princ Pract."},{"issue":"14","key":"bib19-20250430","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.2106\/JBJS.18.00370","article-title":"The Odom criteria: validated at last. A clinimetric evaluation in cervical spine surgery","volume":"101","author":"Broekema","year":"2019","journal-title":"J Bone Joint Surg Am."},{"issue":"2","key":"bib20-20250430","doi-asserted-by":"crossref","first-page":"154","DOI":"10.3171\/2012.10.SPINE12312","article-title":"Assessment of the minimum clinically important difference in pain, disability, and quality of life after anterior cervical discectomy and fusion: clinical article","volume":"18","author":"Parker","year":"2013","journal-title":"J Neurosurg Spine."},{"issue":"7","key":"bib21-20250430","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1177\/21925682211055094","article-title":"Minimally invasive posterior cervical foraminotomy versus anterior cervical fusion and arthroplasty: systematic review and meta-analysis","volume":"12","author":"Platt","year":"2022","journal-title":"Global Spine J."},{"issue":"4","key":"bib22-20250430","doi-asserted-by":"crossref","first-page":"519","DOI":"10.2106\/00004623-199904000-00009","article-title":"Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis","volume":"81","author":"Hilibrand","year":"1999","journal-title":"J Bone Joint Surg Am."},{"issue":"1","key":"bib23-20250430","doi-asserted-by":"crossref","first-page":"E50","DOI":"10.1097\/BSD.0000000000000551","article-title":"Symptomatic adjacent segment disease after anterior cervical discectomy for single-level degenerative disk disease","volume":"31","author":"Donk","year":"2018","journal-title":"Clin Spine Surg."},{"key":"bib24-20250430","doi-asserted-by":"crossref","first-page":"100869","DOI":"10.1016\/j.bas.2022.100869","article-title":"Clinical adjacent segment pathology after anterior cervical discectomy, with and without fusion, for cervical degenerative disc disease: a single center retrospective cohort study with long-term follow-up","volume":"2","author":"Schuermans","year":"2022","journal-title":"Brain Spine."},{"issue":"4","key":"bib25-20250430","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1097\/BSD.0000000000001316","article-title":"Surgical treatment of single level cervical radiculopathy. A comparison of anterior cervical decompression and fusion (ACDF) versus cervical disk arthroplasty (CDA) versus posterior cervical foraminotomy (PCF)","volume":"35","author":"Padhye","year":"2022","journal-title":"Clin Spine Surg."},{"issue":"3","key":"bib26-20250430","first-page":"1","article-title":"Posterior foraminotomy versus anterior decompression and fusion in patients with cervical degenerative disc disease with radiculopathy: up to 5 years of outcome from the national Swedish Spine Register","volume":"32","author":"MacDowall","year":"2019","journal-title":"J Neurosurg Spine."},{"issue":"9","key":"bib27-20250430","doi-asserted-by":"crossref","first-page":"667","DOI":"10.2106\/JBJS.22.01211","article-title":"Short-term neck pain after posterior foraminotomy compared with anterior discectomy with fusion for cervical foraminal radiculopathy. A secondary analysis of the FACET randomized controlled trial","volume":"105","author":"Sim\u00f5es de Souza","year":"2023","journal-title":"J Bone Joint Surg Am."},{"issue":"2","key":"bib28-20250430","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1093\/neuros\/nyy051","article-title":"Comparison of anterior cervical discectomy and fusion to posterior cervical foraminotomy for cervical radiculopathy: utilization, costs, and adverse events 2003 to 2014","volume":"84","author":"Witiw","year":"2019","journal-title":"Neurosurgery."},{"issue":"5","key":"bib29-20250430","doi-asserted-by":"crossref","first-page":"E17","DOI":"10.3171\/2010.1.FOCUS09305","article-title":"Management of unilateral cervical radiculopathy in the military: the cost effectiveness of posterior cervical foraminotomy compared with anterior cervical discectomy and fusion","volume":"28","author":"Tumial\u00e1n","year":"2010","journal-title":"Neurosurg Focus."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.23.00775","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:44:08Z","timestamp":1787751848000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.23.00775"}},"subtitle":["Two-Year Results of the FACET Randomized Noninferiority Study"],"short-title":[],"issued":{"date-parts":[[2024,7,24]]},"references-count":28,"journal-issue":{"issue":"18","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.23.00775","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,24]]}}}