Endoscopic Foraminotomy Using MED System in Cadaveric Specimens

Roh, Sung Woo; Kim, Daniel H.; Cardoso, Alberto C.; Fessler, Richard G.

doi:10.1097/00007632-200001150-00019

Cited by 129 publications

(55 citation statements)

References 20 publications

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“…There is a renewed interest by many surgeons with regard to the posterior approach to treat the paracentral and foraminal cervical disc due to the advancements of minimally invasive surgery and endoscopy with a series of reports detailing excellent treatment outcomes as the anterior approach need a more depth in dissection of structures to reach the cervical disc [2,4,12,14,15,22]. Tumialan et al [24] reported that posterior cervical foraminotomy offers a benefit relative to anterior cervical foraminotomy in immediate short-term direct costs and long-term indirect costs, early mobilization and outcome.…”

Section: Discussionmentioning

confidence: 99%

“…In order to do posterior key hole foraminotomy; it is necessary to remove 4-5 mm from the superior and inferior lamina using a high-speed drill to allow visibility of the dura till the lateral mass then about 4-5 mm from the lateral mass to provide a significantly greater exposure of the exiting nerve root for decompression and removal of laterally herniated disc [22].…”

Section: Discussionmentioning

confidence: 99%

“…Many reports noted the term laminoforaminotomy for management of paracentral and foraminal cervical disc. However, despite the lesser intraoperative and postoperative risks, the laminoforaminotomy has lost ground when compared with anterior approaches for the management of lateral and foraminal cervical pathology [9,22,27].…”

Section: Introductionmentioning

confidence: 99%

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Anatomical study of the cervical nerve roots for posterior foraminotomy: cadaveric study

Barakat

Hussein

2012

Eur Spine J

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Background Anatomical study of the relationship among the cervical nerve roots, intervertebral disc, and lateral mass is important for the neurosurgeon to avoid complications of posterior cervical foraminotomy. Methods Six adult cadavers were studied. The muscles of the back of the neck were removed to expose the cervical vertebrae posteriorly from C3 to C7. We measured the length, height, extent, and angulations of the nerve roots from the medial point of the facet (MPF) after a total laminectomy, then after one-half facetectomy. The height, width, anteroposterior diameter of the lateral mass, then the height and anteroposterior diameter of the neural foramen were also measured. Results After total laminectomy from C3 to C7, all measures were taken from MPF showed that the mean length of the exposed root was 6.5-8.8 mm while vertical distance was 4-5.4 mm and the horizontal distance was 5.1-7.1 mm. Following a medial one-half facetectomy; the mean length of the exposed root was 8.9-12.3 mm, the vertical distance was 5.5-7.3 mm while the horizontal distance was 7.1-9.8 mm. The mean angulations of the nerve roots were 50.9-53.38. There was a significant difference after total laminectomy and medial one-half facetectomy. Conclusion Anatomic and morphologic study of the cervical nerve roots and their relationships to the lateral mass and the intervertebral disc are useful landmarks to reduce the operative complications of the posterior foraminotomy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Anatomical study of the cervical nerve roots for posterior foraminotomy: cadaveric study

Barakat

Hussein

2012

Eur Spine J

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“…In the published cases, a tubular retractor system with an inserted endoscope was used. The diameters of the tubes were between 16 and 20 mm [12,14,19]. The purpose of the current study was to show the technical feasibility of a full-endoscopic approach with more flexibility in combination with the above-described arcocristectomy in order to combine the advantages of both procedures.…”

Section: Discussionmentioning

confidence: 99%

“…To avoid this large tissue trauma, minimally invasive procedures are currently used for one to three level laminectomy and foraminotomy in patients and cadaver studies [12,14,19]. We assume that minimally invasive approaches for extensive cervical stenosis with decompression on multiple levels including protection of stability of the posterior column can reduce narrowing of spinal cord and avoid kyphotic deformity with the need of posterior fusion procedure.…”

Section: Introductionmentioning

confidence: 99%

Full-endoscopic cervical arcocristectomy for the treatment of spinal stenosis: results of a cadaver study

et al. 2012

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Purpose Cervical spondylotic myelopathy is a multifactorial disease that is directly correlated by the degree of spinal stenosis. Surgery remains the best therapy. A posterior approach is often recommended in patients with multilevel dorsal cervical compression. Aim of the present experimental study was to evaluate the feasibility of a fullendoscopic arcocristectomy in a cadaver study. Methods We performed full-endoscopic arcocristectomy on ten formalin-fixed human cervical specimens. Before and after decompression we obtained high-resolution computerized tomography (CT) data to evaluate the diameter of the cervical spinal canal. Results Overall, surgery was possible on 55 segments in ten cadaver specimens. A mean increase of 4.1 mm (±1.2 mm) in the sagittal diameter of the cervical spinal canal could be achieved (p \ 0.05, t test). Conclusions The full-endoscopic arcrocristectomy is feasible and achieves a sufficient decompression. This minimal invasive technique protects most of the dorsal structures and therefore probably preserves biomechanical functions, which has to be proven in future studies.

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Minimally Invasive Spinal Surgery: Evidence-Based Review of the Literature

Lee¹,

Fox²,

Fessler³

2009

Minimally Invasive Surgery in Orthopedics

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Endoscopic Foraminotomy Using MED System in Cadaveric Specimens

Abstract: Posterior cervical foraminotomy, using the microendoscopic technique, is technically feasible and may be applicable to the treatment of foraminal stenosis and laterally located cervical disc herniation. Studies in live animals are currently examining techniques for hemostasis.

Cited by 129 publications

References 20 publications

Anatomical study of the cervical nerve roots for posterior foraminotomy: cadaveric study

Anatomical study of the cervical nerve roots for posterior foraminotomy: cadaveric study

Full-endoscopic cervical arcocristectomy for the treatment of spinal stenosis: results of a cadaver study

Minimally Invasive Spinal Surgery: Evidence-Based Review of the Literature

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