Comparative Analysis With Modified Inclined Technique for Posterior Endoscopic Cervical Foraminotomy in Treating Cervical Osseous Foraminal Stenosis: Radiological and Midterm Clinical Outcomes

Kim, Ji Yeon; Heo, Dong Hwa; Lee, Dong Chan; Kim, Tae Hyun; Park, Choon Keun

doi:10.14245/ns.2244268.134

Cited by 11 publications

(8 citation statements)

References 17 publications

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“…The distance from the midline to the edges of bony decompression was evaluated after FPCF using axial computed tomography (CT) ( Fig. 1B–D ) [ 10 , 16 , 17 ]. Preoperative and preoperative images showing the preserved length of the facet joint surface in the axial plane and the lateral mass in the coronal plane were compared.…”

Section: Methodsmentioning

confidence: 99%

Surgical Outcomes of Full Endoscopic Posterior Cervical Foraminotomy for Proximal Cervical Spondylotic Amyotrophy

Lee,

Ohmori,

Yoneyama

et al. 2024

Asian Spine J

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Study Design: Retrospective analysis of case series.Purpose: This study aimed to clarify the effects of full endoscopic posterior cervical foraminotomy (FPCF) on cervical spondylotic amyotrophy (CSA).Overview of Literature: The method for decompressing the ventral nerve root and anterior horn (AH) in CSA is controversial.Methods: Patients without myelopathy who underwent FPCF for proximal CSA between 2017 and 2022 were analyzed. The outcome measure was the results of the manual muscle testing (MMT) of the deltoid and biceps. Preoperative nerve root and AH compression were evaluated by magnetic resonance imaging. The intervertebral foramen morphology and bony decompression extent were evaluated by computed tomography.Results: FPCF was performed at the C4/5 level and at the C4/5 and C5/6 levels in 14 and 11 patients, respectively. The width of the narrowest intervertebral foramen was significantly narrower on the affected side than on the healthy side at the C4/5 (2.5 mm vs. 3.6 mm) and operated C5/6 (1.9 mm vs. 3.1 mm) levels. AH compression occurred at the C4/5 and C5/6 levels in 28% and 21% of the patients, respectively. Bony decompression was performed laterally beyond the narrowest foramen at the C4/5 and C5/6 levels in 96% and 91% of the patients, respectively. Compared with patients without AH compression, in those with AH compression, the lamina was resected medially by an average of >1.7 mm and >3.6 mm at the C4/5 and C5/6 levels, respectively. Furthermore, 76% and 81% of the facet joint surfaces were preserved at the C4/5 and C5/6 levels, respectively. Postoperative MMT grade improvement was excellent, good, and fair in 64%, 20%, and 16% of the patients, respectively.Conclusions: FPCF was effective for treating proximal CSA.

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Section: Methodsmentioning

confidence: 99%

Surgical Outcomes of Full Endoscopic Posterior Cervical Foraminotomy for Proximal Cervical Spondylotic Amyotrophy

Lee,

Ohmori,

Yoneyama

et al. 2024

Asian Spine J

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“…[3][4][5][6][7][8] Spinal endoscopic techniques have also been developed to reduce the need for additional instruments. 4,9,10 Full endoscopic thoracic approaches have been used to treat thoracic stenosis and have shown good surgical outcomes. [11][12][13][14][15] Biportal endoscopic surgery has also been described as a surgical technique to treat cervical and thoracic spondylotic myelopathy.…”

Section: Introductionmentioning

confidence: 99%

Biportal Endoscopic Posterior Thoracic Laminectomy for Thoracic Spondylotic Myelopathy Caused by Ossification of the Ligamentum Flavum: Technical Developments and Outcomes

Kim

Ha²,

Lee

et al. 2023

Neurospine

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Objective: Advanced biportal endoscopic surgery techniques can be used to treat thoracic myelopathy secondary to ossification of the ligamentum flavum (OLF). This case series elaborates on a feasible biportal endoscopic technique for thoracic OLF removal and evaluates clinical and radiological outcomes.Methods: A biportal endoscopic posterior thoracic laminectomy was performed to remove the thoracic OLF. Surgical techniques have evolved from inside-out piecemeal removal methods to outside-in <i>en bloc</i> removal methods. Preoperative computed tomography was performed to analyze dural ossification and OLF types. Intraoperative videos were reviewed to observe dural ossification and to determine the surgical method. Neurological outcomes were assessed using the Japanese Orthopaedic Association (JOA) score.Results: Clinical symptoms and neurological function improved markedly after surgery (JOA score, preoperative: 12.6 ± 1.0, final follow-up: 15.6 ± 1.2). The mean operation time per segment was not short (106.6 ± 38 minutes). At early experience stages, inside-out piecemeal decompression was used and it caused intraoperative spinal cord injury. However, outside-in <i>en bloc</i> decompression technique did not induce neural complications. Postoperative segmental instability and correlated mechanical back pain were not observed.Conclusion: The biportal endoscopic posterior thoracic approach is an attractive surgical option to treat thoracic spondylotic myelopathy secondary to OLF. Piecemeal inside-out decompression can induce irreversible spinal cord injury, especially in the early experience stages. Outside-in decompression is more efficient and safer than inside-out pattern procedures by minimizing dural manipulation. Nonetheless, this technique is technically demanding and should only be performed in selected patients after acquiring abundant experience with endoscopic spine surgeries.

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“…[1][2][3] Early recovery after surgery and minimal invasiveness are advantages of full endoscopic or biportal endoscopic PCF. 4,5 Compared with lumbar vertebrae, cervical vertebrae have a shorter interval between adjacent 2 segments (Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

Biportal Endoscopic Posterior Cervical Foraminotomy for Adjacent 2-Level Foraminal Lesions Using a Single Approach (Sliding Technique)

Heo

Ha²,

Jang

2023

Neurospine

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Objective: Endoscopic posterior cervical foraminotomy (PCF) using uniportal or biportal endoscopic approach has been performed for cervical foraminal stenosis or foraminal disc herniation. Two-level PCF is possible using a single biportal endoscopic approach. The purpose of this study was to present a technique of biportal endoscopic PCF for contiguous 2-level foraminal lesions using a single approach and its clinical results.Methods: Patients who received 2-level PCF using a single biportal endoscopic approach were enrolled in this study. We analyzed their clinical data including age, sex, complications, and Neck Disability Index (NDI), and visual analogue scale (VAS) of neck and arm. Postoperative magnetic resonance image was taken on the first postoperative day to determine whether there was sufficient decompression.Results: We successfully performed biportal endoscopic PCF for adjacent 2-level foraminal lesions using a single approach (sliding technique) in all 12 patients. There were cervical foraminal disc herniation with foraminal stenosis (5 cases) and 2-level foraminal stenosis (7 cases). Preoperative mean NDI and VAS of arm and neck significantly decreased at 12 months after surgery. Postoperative clinical outcomes were excellent in 5 patients, good in 6 patients, and fair in 1 patient. There was no major complication.Conclusion: Two-level PCF could be performed using a single approach biportal endoscopic surgery with only 2 skin incisions. Clinical outcomes are favorable. This sliding PCF technique using biportal endoscopic approach might be an alternative surgical treatment for contiguous 2-level cervical foraminal pathologic lesions.

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Comparative Analysis With Modified Inclined Technique for Posterior Endoscopic Cervical Foraminotomy in Treating Cervical Osseous Foraminal Stenosis: Radiological and Midterm Clinical Outcomes

Cited by 11 publications

References 17 publications

Surgical Outcomes of Full Endoscopic Posterior Cervical Foraminotomy for Proximal Cervical Spondylotic Amyotrophy

Surgical Outcomes of Full Endoscopic Posterior Cervical Foraminotomy for Proximal Cervical Spondylotic Amyotrophy

Biportal Endoscopic Posterior Thoracic Laminectomy for Thoracic Spondylotic Myelopathy Caused by Ossification of the Ligamentum Flavum: Technical Developments and Outcomes

Biportal Endoscopic Posterior Cervical Foraminotomy for Adjacent 2-Level Foraminal Lesions Using a Single Approach (Sliding Technique)

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