Anterior Cervical Approach: Decompression and Fusion with Cages

2016 ◽  
pp. 107-113
Author(s):  
Alessandro Landi ◽  
Roberto Delfini
Keyword(s):  
Cervical Approach ◽  
Anterior Cervical Approach

Microsurgical Resection of an Intramedullary Spinal Cord Hemangioblastoma Through an Anterior Cervical Approach: 2-Dimensional Operative Video

2020 ◽  
Author(s):  
Kyle Lindsey McCormick ◽  
Nikita Alexiades ◽  
Paul C McCormick
Keyword(s):  
Spinal Cord ◽  
Tumor Resection ◽  
Residual Tumor ◽  
Complete Recovery ◽  
Surgical Removal ◽  
Intramedullary Spinal Cord ◽  
Dural Closure ◽  
Cervical Approach ◽  
Anterior Cervical Approach ◽  
Microsurgical Resection

Abstract This video demonstrates the microsurgical removal of an intramedullary spinal cord hemangioblastoma through an anterior cervical approach. While most spinal hemangioblastomas arise from the dorsal or dorsolateral pial surface and can be safely resected through a posterior approach,1,2 ventral tumors can present a significant challenge to safe surgical removal.3-5 This patient presented with a progressively symptomatic ventral pial based hemangioblastoma at the C5-6 level with large polar cysts extending from C3 to T1. The tumor was approached through a standard anterior cervical exposure with a C5 and C6 corpectomy. Following midline durotomy, the tumor was identified and complete microsurgical resection was achieved. The principles and techniques of tumor resection are illustrated and described in the video. Following tumor resection and dural closure, a fibular allograft was inserted into the corpectomy defect and a C4-C7 fixation plate was placed. The patient was maintained in a supine position for 36 h. He was discharged home on postoperative day 3 in a cervical collar. The patient did well with near-complete recovery of neurological function. Postoperative magnetic resonance imaging at 6 wk showed a substantial resolution of the polar cysts and no evidence of residual tumor. The patient featured in this video consented to the procedure.

scholarly journals A microsurgical anterior cervical approach and the immediate impact of mechanical retractors: A case control study

2015 ◽  
Vol 6 (03) ◽  
pp. 315-319 ◽  
Author(s):  
Rodrigo Ramos-Zúñiga ◽  
Laura Rocío Díaz-Guzmán ◽  
Shannen Velasquez ◽  
Ana Magdalena Macías-Ornelas ◽  
Martín Rodríguez-Vázquez
Keyword(s):  
Soft Tissue ◽  
Case Control Study ◽  
Case Series ◽  
Soft Tissue Injuries ◽  
Radical Change ◽  
Case Control ◽  
Retrospective Case ◽  
Cervical Approach ◽  
Anterior Cervical Approach ◽  
Control Study

Abstract Introduction: A microsurgical anterior cervical approach with discectomy and fusion (MACDF) is one of the most widely used procedures for treating radicular disorders. This approach is highly successful; however, it is not free from complications. These can be associated with soft tissue injuries. Aim of the Study: The recognition of the risks for these complications should be identified for timely prevention and safe treatment. Materials and Methods: Study Design: Retrospective case control study. This study includes a retrospective case series of 37 patients, paying special attention to immediate complications related to the use of mechanical retraction of soft tissue (dysphagia, dysphonia, esophageal lesions and local hematoma); and a comparative analysis of the outcomes after changes in the retraction method. Results: All selected cases had a positive neurological symptom response in relation to neuropathic pain. Dysphagia and dysphonia were found during the first 72 h in 94.1% of the cases in which automatic mechanical retraction was used for more than one hour during the surgical procedure. A radical change was noted in the reduction of the symptoms after the use of only manual protective blades without automatic mechanical retraction: 5.1% dysphagia and 0% dysphonia in the immediate post-operative period, P = 0.001. Conclusions: Soft tissue damage due to the use of automatic retractors in MACDF is not minor and leads to general discomfort in the patient in spite of good neurological results. These problems most often occur when automatic retractors are used continuously for more than 1 hour, as well as when they are used in multiple levels. Dysphagia, dysphonia and local pain decreased with the use of transient manual blades for retraction, and with intermittent release following minimally invasive principles.

scholarly journals Spinal cord compression secondary to vertebral echinococcosis

2016 ◽  
Vol 7 (01) ◽  
pp. 143-146 ◽  
Author(s):  
Abat Sahlu ◽  
Brook Mesfin ◽  
Abenezer Tirsit ◽  
Knut Wester
Keyword(s):  
Muscular Strength ◽  
Cord Compression ◽  
Lower Limbs ◽  
Resonance Imaging ◽  
Limb Weakness ◽  
Lower Limb Weakness ◽  
Cervical Approach ◽  
Anterior Cervical Approach ◽  
Anterior Plating

ABSTRACTWe describe a patient with progressive lower limb weakness and paresthesia 3 days after falling from a considerable height. Magnetic resonance imaging and computed tomography revealed collapsed Th2 and Th3 vertebrae. A tuberculous (TB) spondylitis was suspected, and anti-TB medication was started however with no clinical improvement. She was referred to our center and operated. A 3 level discectomy and 2 level corpectomy were performed with iliac bone grafting and anterior plating via an anterior cervical approach. The patient developed an esophagocutaneous fistula that was repaired and cured. The biopsy specimen showed a hydatid cyst of the vertebra as the cause of the lesion. After the result, she was started on oral albendazole. At follow-up nearly 4 months after surgery, the patient had regained significant power in her lower limbs with a muscular strength of 5/5 in both legs, thus making it possible to walk without support.

ANTERIOR CERVICAL APPROACH FOR THE TREATMENT OF CERVICAL MYELOPATHY

Neurosurgery ◽  
2007 ◽  
Vol 60 (suppl_1) ◽  
pp. S1-64-S1-70 ◽  
Author(s):  
Paul G. Matz ◽  
Patrick R. Pritchard ◽  
Mark N. Hadley
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Surgical Technique ◽  
Cervical Myelopathy ◽  
Cervical Spondylotic Myelopathy ◽  
Clinical Symptoms ◽  
Recovery Of Function ◽  
Surgical Decompression ◽  
Cervical Approach ◽  
Anterior Cervical Approach

Abstract COMPRESSION OF THE spinal cord by the degenerating cervical spine tends to lead to progressive clinical symptoms over a variable period of time. Surgical decompression can stop this process and lead to recovery of function. The choice of surgical technique depends on what is causing the compression of the spinal cord. This article reviews the symptoms and assessment for cervical spondylotic myelopathy (clinically evident compression of the spinal cord) and discusses the indications for decompression of the spinal cord anteriorly.

Anterior cervical approach for repair of laryngotracheoesophageal cleft

1998 ◽  
Vol 33 (2) ◽  
pp. 400-402 ◽  
Author(s):  
G.S Lipshutz ◽  
C.T Albanese ◽  
M.R Harrison ◽  
R.W Jennings
Keyword(s):  
Cervical Approach ◽  
Anterior Cervical Approach

An anterior approach to spinal pathology of the upper thoracic spine through a partial manubriotomy

2011 ◽  
Vol 15 (5) ◽  
pp. 467-471 ◽  
Author(s):  
Fred C. Lam ◽  
Michael W. Groff
Keyword(s):  
Thoracic Spine ◽  
Anterior Approach ◽  
Surgical Pathology ◽  
Anterior Decompression ◽  
Upper Thoracic Spine ◽  
Perioperative Morbidity ◽  
Cervical Approach ◽  
Anterior Cervical Approach ◽  
Upper Thoracic

Surgical pathology in the region of the upper thoracic spine (T1–4) is uncommon compared with other regions of the spine. Often times posterior and posterolateral approaches can be used, but formal anterior decompression often requires a low anterior cervical approach combined with a sternotomy, which yields significant perioperative morbidity. The authors describe a modified low anterior cervical dissection combined with a partial manubriotomy that they have used to successfully access and decompress anterior pathology of the upper thoracic spine. Their modified approach spares the sternoclavicular joints and leaves the sternum intact, decreasing the morbidity associated with these added procedures.

scholarly journals Alterations in axial curvature of the cervical spine with a combination of rotation and extension in the conventional anterior cervical approach

2013 ◽  
Vol 22 (12) ◽  
pp. 2850-2856 ◽  
Author(s):  
Hiroyuki Tanahashi ◽  
Kei Miyamoto ◽  
Akira Hioki ◽  
Nobuki Iinuma ◽  
Takatoshi Ohno ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Cervical Approach ◽  
Anterior Cervical Approach ◽  
Axial Curvature

A new retractor for the anterior cervical approach

1994 ◽  
Vol 8 (4) ◽  
pp. 469-470 ◽  
Author(s):  
A. Fahir Özer ◽  
T. Ali Zirh
Keyword(s):  
Cervical Approach ◽  
Anterior Cervical Approach

scholarly journals The Application of Endoscopic Technique in High Cervical Anterior Approach to the Craniovertebral Junction

2020 ◽  
Author(s):  
Jiangtao Liu ◽  
Hongming Ji ◽  
Gangli Zhang ◽  
Shengli Chen ◽  
Shiyuan Zhang ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Surgical Approach ◽  
Anterior Approach ◽  
Craniovertebral Junction ◽  
Close Proximity ◽  
Cervical Approach ◽  
Anterior Cervical Approach ◽  
Surgical Corridor ◽  
High Cervical ◽  
Neurovascular Structures

Abstract Objectives: Surgery on the craniovertebral junction (CVJ) presents particular challenges owing to the close proximity of critical neurovascular structures and the brainstem. It is difficult for classic approaches to obtain the extra exposure of neurovascular structures of the CVJ in practice.The surgical approach to the craniovertebral junction (CVJ) offers specific challenges. We explored the feasibility of an endoscope-assisted high anterior cervical approach to the CVJ. Methods: We quantitatively assessed the surgical corridor to, and extent of exposure of, the CVJ in six cadaveric specimens, using 0° and 30° endoscopes. Results: The endoscope provided sufficient exposure of neurovascular structures and the brainstem in the CVJ. Resection of the anterior arch of C1 was avoided in minimal anterior clivectomy. After removing the odontoid, greater exposure of the CVJ was obtained. Conclusion: An endoscope-assisted high anterior cervical approach to the CVJ preserves cervical spine stability while minimizing the risk of neurovascular injury within the surgical corridor.

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