{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T16:07:40Z","timestamp":1776096460921,"version":"3.50.1"},"reference-count":70,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,9]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Posterior cervical foraminotomy (PCF) for the treatment of radiculopathy can be performed via open, minimally invasive (MIS), or more recently emerging endoscopic approaches. Although proponents of endoscopy cite decreased postoperative pain as an advantage compared with open or MIS approaches, few studies have been performed to evaluate this outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors retrospectively identified all patients undergoing PCF at a single institution from January 1, 2015, to June 1, 2024. Patients were stratified by operative approach (open, MIS, or uniportal endoscopic). The primary outcome was opioid consumption at 6 weeks, 3 months, and 6 months postoperatively, as well as cumulative opioid consumption in morphine milligram equivalents (MME) at each time interval. Secondary outcomes included short-term perioperative outcomes such as complications, operative duration, pain relief, and reoperation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>One hundred thirty-eight patients met inclusion criteria, of whom 37 underwent open, 67 underwent MIS, and 34 underwent uniportal endoscopic procedures. Patients undergoing MIS and endoscopic approaches had lower rates of opioid use at 6 weeks compared with open approaches (relative risk 0.51 and 0.39, respectively). Endoscopic procedures were associated with lower total opioid MME within 6 weeks than both MIS and open procedures (238.4 vs 479.4 vs 753.8), although MIS and endoscopic procedures had similar rates of opioid use at 6 weeks. A subgroup analysis of a propensity score\u2013matched cohort based on preoperative demographic data revealed a similar association between operative approach and total MME, although there were no significant differences between the cohorts in the proportion of patients using opioids at any of the follow-up intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>In this retrospective analysis, both endoscopic and MIS PCF were associated with lower overall rates and amount of opioid use with similar rates of short-term complications, reoperations, and pain relief as open approaches.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.8.spine25515","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:00:16Z","timestamp":1769083216000},"page":"330-339","source":"Crossref","is-referenced-by-count":0,"title":["A retrospective comparative analysis of postoperative opioid utilization following uniportal endoscopic versus minimally invasive versus open approaches for posterior cervical foraminotomy"],"prefix":"10.3171","volume":"44","author":[{"given":"Darius","family":"Ansari","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Garret P.","family":"Greeneway","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"Talbot","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathaniel P.","family":"Brooks","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Wisconsin Hospital and Clinics, Madison, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"Musculoskeletal Care","first-page":"555","article-title":"Cervical spine radiculopathy epidemiology: a systematic review","volume":"18","author":"Mansfield M","year":"2020","unstructured":"Mansfield M, Smith T, Spahr N, Thacker M. Cervical spine radiculopathy epidemiology: a systematic review. Musculoskeletal Care. 2020;18(4):555\u2013567."},{"issue":"5","key":"b2","series-title":"J Spinal Disord Tech","first-page":"E251","article-title":"Cervical radiculopathy: epidemiology, etiology, diagnosis, and treatment","volume":"28","author":"Woods BI","year":"2015","unstructured":"Woods BI, Hilibrand AS. Cervical radiculopathy: epidemiology, etiology, diagnosis, and treatment. J Spinal Disord Tech. 2015;28(5):E251\u2013E259."},{"issue":"1","key":"b3","series-title":"J Neurosurg","first-page":"41","article-title":"Outpatient surgical treatment of cervical radiculopathy","volume":"87","author":"Tomaras CR","year":"1997","unstructured":"Tomaras CR, Blacklock JB, Parker WD, Harper RL. Outpatient surgical treatment of cervical radiculopathy. J Neurosurg. 1997;87(1):41\u201343."},{"issue":"14","key":"b4","series-title":"Spine (Phila Pa 1976)","first-page":"1226","article-title":"Epidemiological trends in cervical spine surgery for degenerative diseases between 2002 and 2009","volume":"38","author":"Oglesby M","year":"2013","unstructured":"Oglesby M, Fineberg SJ, Patel AA, Pelton MA, Singh K. Epidemiological trends in cervical spine surgery for degenerative diseases between 2002 and 2009. Spine (Phila Pa 1976). 2013;38(14):1226\u20131232."},{"issue":"9","key":"b5","series-title":"Spine (Phila Pa 1976)","first-page":"940","article-title":"Full-endoscopic cervical posterior foraminotomy for the operation of lateral disc herniations using 5.9-mm endoscopes: a prospective, randomized, controlled study","volume":"33","author":"Ruetten S","year":"2008","unstructured":"Ruetten S, Komp M, Merk H, Godolias G. Full-endoscopic cervical posterior foraminotomy for the operation of lateral disc herniations using 5.9-mm endoscopes: a prospective, randomized, controlled study. Spine (Phila Pa 1976). 2008;33(9):940\u2013948."},{"issue":"4","key":"b6","series-title":"Orthop Surg","first-page":"425","article-title":"Comparison of anterior cervical discectomy and fusion versus posterior cervical foraminotomy in the treatment of cervical radiculopathy: a systematic review","volume":"8","author":"Liu WJ","year":"2016","unstructured":"Liu WJ, Hu L, Chou PH, Wang JW, Kan WS. Comparison of anterior cervical discectomy and fusion versus posterior cervical foraminotomy in the treatment of cervical radiculopathy: a systematic review. 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Adv Orthop. 2022;2022:1026547."},{"issue":"1","key":"b9","series-title":"Orthop Clin North Am","first-page":"137","article-title":"Minimally invasive approaches to the cervical spine","volume":"43","author":"Celestre PC","year":"2012","unstructured":"Celestre PC, Pazmi\u00f1o PR, Mikhael MM,  Minimally invasive approaches to the cervical spine. Orthop Clin North Am. 2012;43(1):137\u2013147."},{"issue":"2","key":"b10","series-title":"JAMA Surg","first-page":"158","article-title":"Current issues in the use of opioids for the management of postoperative pain: a review","volume":"157","author":"Macintyre PE","year":"2022","unstructured":"Macintyre PE, Quinlan J, Levy N, Lobo DN. Current issues in the use of opioids for the management of postoperative pain: a review. JAMA Surg. 2022;157(2):158\u2013166."},{"issue":"2","key":"b11","series-title":"J Neurosurg Spine","first-page":"154","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 SL","year":"2013","unstructured":"Parker SL, Godil SS, Shau DN, Mendenhall SK, McGirt MJ. Assessment of the minimum clinically important difference in pain, disability, and quality of life after anterior cervical discectomy and fusion: clinical article. J Neurosurg Spine. 2013;18(2):154\u2013160."},{"issue":"1","key":"b12","series-title":"Bioinformatics","first-page":"112","article-title":"MissForest\u2014non-parametric missing value imputation for mixed-type data","volume":"28","author":"Stekhoven DJ","year":"2012","unstructured":"Stekhoven DJ, B\u00fchlmann P. MissForest\u2014non-parametric missing value imputation for mixed-type data. 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J Neurosurg Spine. 2023;38(6):631\u2013643."},{"issue":"18","key":"b17","series-title":"Spine (Phila Pa 1976)","first-page":"1266","article-title":"Single-level anterior cervical discectomy and fusion results in lower five-year revisions than posterior cervical foraminotomy in a large national cohort","volume":"48","author":"Jayaram RH","year":"2023","unstructured":"Jayaram RH, Joo PY, Gouzoulis MJ, Ratnasamy PP, Caruana DL, Grauer JN. Single-level anterior cervical discectomy and fusion results in lower five-year revisions than posterior cervical foraminotomy in a large national cohort. 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Comparison of anterior cervical discectomy and fusion versus posterior cervical foraminotomy in the treatment of cervical radiculopathy: a systematic review. Orthop Surg. 2016;8(4):425\u2013431."},{"issue":"8","key":"b7","series-title":"J Clin Neurosci","first-page":"1090","article-title":"A single neurosurgical center\u2019s experience of the resolution of cervical radiculopathy after dorsal foraminotomy and ventral discectomy","volume":"18","author":"Schebesch KM","year":"2011","unstructured":"Schebesch KM, Albert R, Sch\u00f6del P, Proescholdt M, Lange M, Brawanski A. A single neurosurgical center\u2019s experience of the resolution of cervical radiculopathy after dorsal foraminotomy and ventral discectomy. J Clin Neurosci. 2011;18(8):1090\u20131092."},{"key":"b8","series-title":"Adv Orthop","first-page":"1026547","article-title":"Opioid sparing analgesics in spine surgery","volume":"2022","author":"Reed LA","year":"2022","unstructured":"Reed LA, Patel M, Luque K, Theiss SM. 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