Posterior approach for soft cervical disc herniation: a neglected technique?

Rodrigues, Marcelo Alvarez; Hanel, Ricardó A.; Prevedello, Daniel M.; Antoniuk, Affonso; Araújo, João Cândido

doi:10.1016/s0090-3019(00)00349-9

Cited by 29 publications

(31 citation statements)

References 22 publications

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“…They found significant segmental hypermobility occurred with greater than 50% facet resection and noted that resection of the facet should be limited to less than 50% to preserve the biomechanical function of the cervical vertebrae and to avoid the risk of cervical instability. This was confirmed by many authors [3,6,20,21].…”

Section: Discussionsupporting

confidence: 71%

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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: Discussionsupporting

confidence: 71%

“…1.1 mm. So, according to the previous reports [3,6,20,21] and our results; it is safe to remove up to 5 mm of the lateral mass to allow easy mobilization of the nerve roots for discectomy without instability.…”

Section: Discussionsupporting

confidence: 68%

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

Barakat

Hussein

2012

Eur Spine J

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“…6 Due to ease and familiarity, most neurosurgeons prefer anterior discectomy with interbody fusion for the operative treatment of herniated cervical disc. [2][3][4] However, these open surgeries usually require entering into the spinal canal with the attendant risk of complications such as epidural hematoma, graft extrusion, transient hoarseness, and dysphagia.…”

Section: Discussionmentioning

confidence: 99%

“…1 In general, patients with cervical myelopathy or radiculopathy have been treated with open surgeries such as anterior discectomy with or without fusion, anterior foraminotomy, and posterior foraminotomy with or without laminectomy. [2][3][4][5][6][7] However, if the patients have radiculopathy alone due to soft disc herniation and no response to conservative therapy, the minimally invasive approach under local anesthesia can be effective for pain relief.…”

Section: Introductionmentioning

confidence: 99%

Immediate Pain Improvement Is a Useful Predictor of Long-Term Favorable Outcome after Percutaneous Laser Disc Decompression for Cervical Disc Herniation

Lee

Ahn

Choi

et al. 2006

Photomedicine and Laser Surgery

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14] Historically, the routine surgical approach for symptoms produced by cervical disc disease, similar to lumbar procedures, 15 was posterior. 16 After Spurling and Scoville 17 reported the successful removal of cervical discs with laminectomy in 1944, the posterior approach for the treatment of cervical radiculopathy has evolved into keyhole foraminotomy being popularized by Frykholm.…”

mentioning

confidence: 99%

Posterior Foraminotomy or Anterior Discectomy With Polymethyl Methacrylate Interbody Stabilization for Cervical Soft Disc Disease: Results in 292 Patients With Monoradiculopathy

Korinth

Krüger

Oertel

et al. 2006

Spine

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The findings show that apparently a higher success rate results after anterior microdiscectomy with PMMA interbody stabilization for treatment of degenerative cervical monoradiculopathy than after posterior foraminotomy. Considering the type of morphology of the pathology that causes the radiculopathy, pure soft discs have a better outcome than mixtures of soft and hard discs, independent of the chosen approach. Although statistically significant differences in clinical data were found in both groups, both approaches seem to have equivalent value in individual indications.

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Posterior approach for soft cervical disc herniation: a neglected technique?

Cited by 29 publications

References 22 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

Immediate Pain Improvement Is a Useful Predictor of Long-Term Favorable Outcome after Percutaneous Laser Disc Decompression for Cervical Disc Herniation

Posterior Foraminotomy or Anterior Discectomy With Polymethyl Methacrylate Interbody Stabilization for Cervical Soft Disc Disease: Results in 292 Patients With Monoradiculopathy

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