Abstract
A prospective analysis of the first twenty patients operated for cervical radiculopathy by a new modification of transcorporeal anterior cervical foraminotomy technique. To evaluate early results of a functional disc surgery in which decompression for the cervical radiculopathy is done by drilling a hole in the upper vertebral body and most of the disc tissue is preserved. Earlier approaches to cervical disc surgery either advocated simple discectomy or discectomy with fusion, ultimately leading to loss of motion segment. Posterior foraminotomy does not address the more common anterior lesion. Twenty patients suffering from cervical radiculopathy not responding to conservative treatment were chosen for the new technique. Upper vertebral transcorporeal foraminotomy was performed with the modified technique in all the patients. All the patients experienced immediate/early relief of symptoms. No complications of vertebral artery injury, Horner’s syndrome or recurrent laryngeal nerve palsy were noted. Modified transcorporeal anterior cervical microforaminotomy is an effective treatment for cervical radiculopathy. It avoids unnecessary violation of the disc space and much of the bony stabilizers of the cervical spine. Short-term results of this technique are quite encouraging. Longer-term analysis can help in outlining the true benefits of this technique.
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References
An HS, Takegami K, Kamada H et al (2004) Intradiscal administration of osteogenic protein-1 increases intervertebral disc height and proteoglycan content in the nucleus pulposus in normal adolescent rabbits. Spine 30:25–32
Benini A, Krayenbuhl H, Bruderl R (1982) Anterior cervical discectomy without fusion. Microsurgical technique. Acta Neurochir (Wien) 61(1–3):105–110
Clements DH, O’Leary PF (1990) Anterior cervical discectomy and fusion. Spine 15:1023–1025
Cloward RB (1958) The anterior approach for removal of ruptured cervical discs. J Neurosurg 15:602
DePalma AF, Rothman RH, Lewinnek GE et al (1972) Anterior interbody fusion for severe disc degeneration. Surg Gynecol Obstet 134:755–758
Dmitriev AE, Cunningham BW, Hu N et al (2005) Adjacent level intradiscal pressure and segmental kinematics following a cervical total disc arthroplasty: An in vitro human cadaveric model. Spine 30:1165–1172
Ebersold MJ, Raynor RB, Bovis GK et al (1999) Cervical laminotomy, laminectomy, laminoplasty and foraminotomy. In: Benzel EC (ed) Spine surgery:techniques, complication avoidance and management. Churchill Livingstone, London, pp 251–253
Fessler RG, Khoo LR (2002) Minimally invasive cervical microendoscopic foraminotomy: an initial clinical experience. Neurosurgery 51(Suppl 2):37–45
George B, Zerah M, Lot G et al (1993) Oblique transcorporeal approach to anteriorly located lesions in the cervical spinal canal. Acta Neurochir 121:187–190
Hakuba A (1976) Trans-unco-discal approach. A combined anterior and lateral approach to cervical discs. J Neurosurg 45:284–291
Hankinson HL, Wilson CB (1973) Use of the operating microscope in anterior cervical discectomy without fusion. J Neurosurg 43:452–456
Hilibrand AS, Carlson GD, Palumbo MA et al (1999) Radiculopathy and Myelopathy at segments adjacent to the site of a previous anterior cervical Arthrodesis. JBJS 81:519–528
Hilibrand AS, Yoo JU, Carlson GD et al (1997) The success of anterior cervical Arthrodesis adjacent to previous fusion. Spine 22:1574–1579
Jho HD (1996) Microsurgical anterior cervical foraminotomy. A new approach to cervical disc herniation. J Neurosurg 84:155–160
Jho HD, Kim WK, Kim MH (2002) Anterior microforaminotomy for treatment of cervical radiculopathy: part i—disc preserving “functional cervical disc surgery”. Neurosurgery 51(Suppl-2):46–53
Lesoin F, Biondi A, Jomin M (1987) Foraminal cervical herniatied disc treated by anterior discoforaminotomy. Neurosurg 21:334–338
Lu DS, Shono Y, Oda I et al (1997) Effects of chondroitinase ABC and chymopapain on spinal motion segment biomechanics. An in vivo biomechanical, radiologic, and histologic canine study. Spine 22:1828–1834; discussion 34–35
Lundsford LD, Bissonette JD, Jannetta PJ et al (1973) Anterior surgery for cervical disc disease. Part 1: treatment of lateral cervical disc herniation in 253 cases. J Neurosurg 53:679–683
Martins AN (1976) Anterior cervical discectomy with and without interbody bone graft. J Neurosurg 44:290–295
Pospiech J, Stolke D, Wilke HJ et al (1999) Intradiscal pressure recordings in the cervical spine. Neurosurgery 44:379–385
Prolo DJ, Oklund SA, Butcher M (1986) Towards uniformity in evaluating results of lumbar spine operations: A paradigm applied to posterior lumbar interbody fusions. Spine 11(6):601–606
Raynor RB, Pugh J, Shapiro I (1985) Cervical facetectomy and the effect on spine strength. J Neurosurg 63:278–282
Sampath P, Bendebba M, Davis J et al (1999) Outcome in patients with cervical radiculopathy: prospective, multicenter study with independent clinical review. Spine 24:591–597
Saringer W, Nobauer I, Reddy M et al (2002) Microsurgical anterior cervical foraminotomy (Uncoforaminotomy) for unilateral radiculopathy: clinical results of a new technique. Acta Neurochir 144:685–694
Savoluinen S, Usenius JP, Hernesniemi J (1994) Iliac crest versus artificial bone grafts in 250 cervical fusions. Acta Neurochir 129:54–57
Schimandle JH, Boden SD (2003) Degenerative disorders of the cervical spine: cervical radiculopathy. In: Emery SE, Boden SD (eds) Surgery of the cervical spine, saunders. Elsevier Science, Philadelphia 94
Smith EW, Robinson RA (1958) The treatment of certain cervical spine disorders by anterior removal of the intervertebral disc and interbody fusion. JBJS [A] 40:607
Snyder GM, Bernhardt AM (1989) Anterior cervical fractional interspace decompression for treatment of cervical radiculopathy. A review of the first 66 cases. Clin Orthop 246:92–99
Urban JP, Holm S, Maroudas A et al (1977) Nutrition of the intervertebral disk. An in vivo study of solute transport. Clin Orthop Relat Res 101–114
Urban JP, Holm S, Maroudas A et al (1982) Nutrition of the intervertebral disc: effect of fluid flow on solute transport. Clin Orthop Relat Res 296–302
Verbiest H (1968) A lateral approach to cervical spine: technique and indications. J Neurosurg 28:191–203
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We are thankful to Sung Hui Myung, Song-Woo Shin, and Chi Gon Oh for their help in preparing the manuscript.
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Choi, G., Lee, SH., Bhanot, A. et al. Modified transcorporeal anterior cervical microforaminotomy for cervical radiculopathy: a technical note and early results. Eur Spine J 16, 1387–1393 (2007). https://doi.org/10.1007/s00586-006-0286-6
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DOI: https://doi.org/10.1007/s00586-006-0286-6