Cervical disc prolapse is a common disorder that results in spinal cord compression causing myelopathy or nerve root compression causing radiculopathy or both. For a posterolateral cervical disc prolapse causing radiculopathy, the common surgical approach used nowadays is the anterior approach to the cervical column. However, this is associated with many complications; some of them are devastating for example, carotid artery injury and cord injury. Therefore, the use of a simpler approach for

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... e posterolateral disc prolapse is needed. The posterior approach making a keyhole foraminotomy is simpler. Aim of the work: The aim of this work was to evaluate the role of posterior keyhole foraminotomy for the treatment of cervical radiculopathy caused by posterolateral cervical disc prolapse as compared to the anterior approach for cervical discectomy. Methods: A retrospective study included 20 patients diagnosed with posterolateral cervical disc prolapse causing radiculopathy and they were divided into two groups each composed of 10 patients, group (1) had cervical anterior discectomy and group (2) had posterior cervical keyhole foraminotomy. Results: Cervical posterior keyhole foraminotomy (group (2)) had much better results than the cervical anterior discectomy (group (1)). The duration of surgery was shorter in group (2) than in group (1). Also, the postoperative complications including dysphagia, hemiparesis and myelopathy were present only in group (1). The postoperative improvement was better in group (2) than in group (1) and the postoperative hospital stay was shorter in group (2) than in group (1). Conclusion: As compared to cervical anterior discectomy, cervical posterior keyhole foraminotomy is a safe and effective approach for surgical treatment of posterolateral cervical disc prolapse causing nerve root compression resulting in brachialgia. Cervical keyhole foraminotomy has a shorter duration of surgery, less incidence of complications, less duration of postoperative hospital stay and a better improvement in symptoms.