Microendoscopic posterior cervical foraminotomy: a cadaveric model and clinical application for cervical radiculopathy

Burke, Timothy G.; Caputy, Anthony J.

doi:10.3171/spi.2000.93.1.0126

Cited by 45 publications

(27 citation statements)

References 10 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%

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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%

“…The advantages of the posterior approach include, (1) avoid damage to vital structures located in the anterior area of the cervical spine, (2) avoid the structural and biomechanical damage to the remaining vertebral disc (joint morbidity, bone graft complication, as well as the adjacent joint syndrome) [4,12,14,17].…”

Section: Introductionmentioning

confidence: 99%

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

Barakat

Hussein

2012

Eur Spine J

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“…Great advances have been made with the posterior approach with the development of equipment such as the microscope and the endoscope. Advantages of the posterior approach include an ability to avoid damage to vital structures located in the anterior area of the cervical spine (i.e., the trachea, esophagus, internal carotid artery, vertebral artery, thoracic duct, and recurrent laryngeal nerve), an ability to prevent structural and biomechanical damage to the remaining vertebral disc by preserving it, an ability to lower the morbidity associated with the joint, and an ability to reduce the occurrence of complications associated with the bone graft, as well as degenerative changes at the adjacent joint 2,[9][10][11]16,18) . In cases where only dorsal decompression of the nerve root is performed and only fragments of the intervertebral disc are removed, excellent treatment outcomes have also been reported 7,8,12,20) .…”

Section: Introductionmentioning

confidence: 99%

Morphometric Study of the Nerve Roots Around the Lateral Mass for Posterior Foraminotomy

Hwang

Bae

Cho

et al. 2010

J Korean Neurosurg Soc

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Objective : Morphometric data on dorsal cervical anatomy were examined in an effort to protect the nerve root near the lateral mass during posterior foraminotomy. Methods : Using 25 adult formalin-fixed cadaveric cervical spines, measurements were taken at the lateral mass from C3 to C7 via a total laminectomy and a medial one-half facetectomy. The morphometric relationship between the nerve roots and structures of the lateral mass was investigated. Results from both genders were compared. Results : Following the total laminectomy, from C3 to C7, the mean of the vertical distance from the medial point of the facet (MPF) of the lateral mass to the axilla of the root origin was 3.2-4.7 mm. The whole length of the exposed root had a mean of 4.2-5.8 mm. Following a medial onehalf facetectomy, from C3 to C7, the mean of the vertical distance to the axilla of the root origin was 2.1-3.4 mm, based on the MPF. Mean vertical distances from the MPF to the medial point of the root that crossed the inferior margin of the intervertebral disc were 1.2-2.7 mm. The mean distance of the exposed root was 8.2-9.0 mm, and the mean angle between the dura and the nerve root was significantly different between males and females, at 53.4-68.4°. Conclusion : These data will aid in reducing root injuries during posterior cervical foraminotomy.

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“…and 246g, respectively. On the other hand, the mean surgical time of endoscopic foraminotomy was reported 28-184 minutes and the mean blood loss volume of that was reported no measurable blood loss to 138 ml [14,17,18]. I think that the surgical invasion of MOF is almost equal compare to endoscopic foraminotomy.…”

Section: Discussionmentioning

confidence: 98%

Mini Open Foraminotomy (MOF) for Cervical Radiculopathy: Technical Note

Takahashi¹,

Aoki²,

Ogihara³

et al. 2009

TOSPINEJ

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Abstract:Background: Favorable surgical results had been reported in cervical posterior foraminotomy using endoscopy; however, the learning curve for the surgeon is steep. We therefore developed a procedure that can be performed more easily and with small incision, called "Mini Open Foraminotomy (MOF)", using a tubular retractor (22mm diameter) under direct vision. The purpose of this study was to demonstrate the surgical procedure about MOF for cervical radiculopathy and assess a postoperative result of MOF. Materials/Methods:We performed MOF on 19 consecutive patients (15 males and 4 females) with cervical radiculopathy. Average age at time of operation was 48.9 years. Average follow-up period was 30.6 months. Spondylotic radiculopathy was diagnosed in 12 cases and disc herniation in seven cases. Skin incision was approximately 3 cm. Large (22mm diameter) METRx tube with illumination was fixed into paravertebral muscle. The lower articular process of the upper vertebra and the upper articular process of the lower vertebra were shaved with pneumatic drill and Kerrison rongeur to decompress the nerve root under direct vision.Results: Mean operation time was 78±26 minutes. Mean hemorrhage weight was 50±46ml. All patients were able to stand and walk without neck collars on the first postoperative day, with dramatic reduction of radicular pain. Mean VAS of radicular pain showed significant improvement at final follow up compared with that before surgery (0.5±1.1 and 7.1±2.6, respectively; p<0.0001). Conclusions:Mini open foraminotomy is a less invasive, more easily, and safe procedure, moreover effective surgical option for the management of cervical radiculopathy.

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Microendoscopic posterior cervical foraminotomy: a cadaveric model and clinical application for cervical radiculopathy

Cited by 45 publications

References 10 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

Morphometric Study of the Nerve Roots Around the Lateral Mass for Posterior Foraminotomy

Mini Open Foraminotomy (MOF) for Cervical Radiculopathy: Technical Note

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