Microsurgical Cervical Nerve Root Decompression by Anterolateral Approach

2006 ◽  
Vol 58 (suppl_1) ◽  
pp. ONS-103-ONS-107 ◽  
Author(s):  
Michaël Bruneau ◽  
Jan Frédérick Cornelius ◽  
Bernard George
Keyword(s):  
Minimally Invasive ◽  
Nerve Root ◽  
Cervical Radiculopathy ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Anterolateral Approach ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Neurosurgical Procedure ◽  
Nerve Root Decompression

Abstract OBJECTIVE: Cervical radiculopathy caused by a posterolateral soft disc herniation or spondylosis is a common pathology. METHODS: Decompression of a stressed cervical nerve root is a routine neurosurgical procedure. Most of the time it is achieved through an anterior approach and, less frequently, through a posterior approach in specific indications. RESULTS: According to the principles that an anterolateral compression must directly be reached and that working in the vicinity of the vertebral artery is safe under visual control, we developed the anterolateral approach to the cervical intervertebral foramen and the nerve root using a minimally invasive technique to remove the offending process. CONCLUSION: Microsurgical cervical nerve root decompression by anterolateral approach is a minimally invasive technique, permitting one to remove the offending process staightforwardly. The disc and bone resections are minimal. This method avoids osteoarthrodesis or arthroplasty with disc prosthesis. This technique is efficient with good results and low morbidity.

MICROSURGICAL CERVICAL NERVE ROOT DECOMPRESSION VIA AN ANTEROLATERAL APPROACH

Neurosurgery ◽  
2007 ◽  
Vol 61 (5) ◽  
pp. 972-980 ◽  
Author(s):  
Jan Frederick Cornelius ◽  
Michaël Bruneau ◽  
Bernard George
Keyword(s):  
Neck Pain ◽  
Nerve Root ◽  
Radicular Pain ◽  
Anterolateral Approach ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Surgical Data ◽  
Nerve Root Decompression

Abstract OBJECTIVE We previously reported our technique of selective microforaminotomy via an anterolateral approach for the treatment of spondylotic radiculopathy. We now report the clinical long-term results. METHODS A retrospective study of 40 patients who consecutively underwent operation via this technique was performed. Patients' demographic, clinical presentation, and radiological and surgical data were recorded by chart review. Long-term clinical outcome was assessed by a questionnaire, office visits, and intensive telephone interviews. The results were compared with the literature. RESULTS The study was comprised of 22 women and 18 men with a mean age of 50.6 years (age range, 33.1–75.2 yr). Preoperatively, 98% (n = 39) of the patients presented radicular pain, 88% (n = 35) of the patients presented with neck pain, 75% (n = 30) of the patients presented with a sensory deficit, and 45% (n = 18) of the patients presented with a motor deficit. Patients underwent operation at one level (n = 15), two levels (n = 23), or three levels (n = 2). One patient underwent operation bilaterally in a two-step procedure. In total, 68 cervical nerve roots were completely decompressed by this technique. On the basis of preoperative x-ray criteria of instability, two patients (5%) required graft arthrodesis, which was performed during the same surgery after the nerve root decompression. After a mean follow-up period of 4.3 years (range, 2.7–7.4 yr), 85% of the patients have no residual radicular pain, 94% of the patients have no more neck pain, 90% of the patients recovered from their sensory deficits, and 83% of the patients recovered from their motor deficits. According to Odom's criteria, 95% achieved an excellent or good outcome (Odom Grades I and II). No postoperative instability occurred. The transient and permanent morbidity rates were 7.5% (n = 3) and 2.5% (n = 1), respectively; one patient has permanent Horner's syndrome. CONCLUSION The technique of microsurgical cervical nerve root decompression by selective microforaminotomy via an anterolateral approach is safe and efficient for the treatment of spondylotic radiculopathy. The morbidity rate is low. Clinical results are good after a long-term follow-up period. This technique allows the preservation of cervical motion and spinal stability. The results compare favorably to those of the literature.

CERVICAL RADICULOPATHY

Neurosurgery ◽  
2007 ◽  
Vol 60 (suppl_1) ◽  
pp. S1-28-S1-34 ◽  
Author(s):  
Khalid M. Abbed ◽  
Jean-Valéry C.E. Coumans
Keyword(s):  
Physical Examination ◽  
Nerve Root ◽  
Cervical Spondylosis ◽  
Cervical Radiculopathy ◽  
Cervical Disc ◽  
Common Condition ◽  
Neural Foramen ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Entrapment Neuropathies

Abstract CERVICAL RADICULOPATHY IS a common condition that usually results from compression and inflammation of the cervical nerve root or roots in the region of the neural foramen. It is frequently caused by cervical disc herniation and cervical spondylosis. The diagnosis can be established by history and physical examination, but care should be taken, as diagnoses can mimic or coexist with cervical radiculopathy, such as entrapment neuropathies. The pathophysiology, presentation, and clinical evaluation of cervical radiculopathy are discussed.

scholarly journals A novel sling technique for microvascular decompression of a rare anomalous vertebral artery causing cervical radiculopathy

2013 ◽  
Vol 35 (3) ◽  
pp. E2 ◽  
Author(s):  
Adesh Tandon ◽  
Sid Chandela ◽  
David Langer ◽  
Chandranath Sen
Keyword(s):  
Conservative Management ◽  
Microvascular Decompression ◽  
Nerve Root ◽  
Treatment Options ◽  
Cervical Radiculopathy ◽  
Occipital Neuralgia ◽  
Nerve Root Compression ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Vertebral Arteries

Cervical radiculopathy secondary to compression from congenital anomalous vertebral arteries (VAs) is a known entity. Patients present with a variety of symptoms ranging from upper-extremity numbness to true occipital neuralgia. Treatment options for extracranial tortuous VAs include conservative management or some form of surgical microvascular decompression (MVD). The authors report on a patient with a congenital anomalous VA loop causing cervical nerve root compression. Successful MVD was conducted with relief of the patient's symptoms. A novel sling technique was used for mobilization of the VA. To the authors' knowledge, this is the first MVD described utilizing this technique.

scholarly journals A Comparative Study on the Minimal Invasiveness of Full-Endoscopic and Microendoscopic Cervical Foraminotomy Using Intraoperative Motor Evoked Potential Monitoring

Medicina ◽  
2020 ◽  
Vol 56 (11) ◽  
pp. 605
Author(s):  
Masahiro Hirahata ◽  
Tomoaki Kitagawa ◽  
Muneyoshi Fujita ◽  
Ryutaro Shiboi ◽  
Hirotaka Kawano ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Nerve Root ◽  
Evoked Potential ◽  
Motor Evoked Potential ◽  
Cervical Radiculopathy ◽  
Improvement Rate ◽  
Minimal Invasiveness ◽  
Average Improvement ◽  
Nerve Root Decompression ◽  
Cervical Foraminotomy

Background and Objectives: Full-endoscopic cervical foraminotomy (FECF) and microendoscopic cervical foraminotomy (MECF) are effective surgeries for cervical radiculopathy and are considered minimally invasive in terms of damage to paraspinal soft tissue. However, no studies have quantitatively compared FECF and MECF in terms of neurological invasiveness. The aim of this study was to compare the neurological invasiveness of FECF and MECF using intraoperative motor evoked potential (MEP) monitoring. Materials and Methods: A chart review was conducted of 224 patients with cervical radiculopathy who underwent FECF or MECF between April 2014 and March 2020. Patients were 37 women and 187 men, with a mean age of 51 (range, 21–86) years. FECF was performed in 143 cases and MECF was performed in 81 cases. Results: Average MEP amplitude significantly increased from 292 mV before to 677 mV after nerve root decompression in patients who underwent the FECF. The average improvement rate was 273%. In patients who underwent the MECF, average MEP amplitude significantly increased from 306 mV before to 432 mV after nerve root decompression. The average improvement rate was 130%. The improvement rate was significantly higher for FECF compared with MECF. Conclusions: MEP amplitude increased after nerve root decompression in both FECF and MECF, but the improvement rate was higher in FECF. These results suggest that FECF might be more minimally invasive than MECF in terms of neurological aspects.

Cervical Radiculopathy

2017 ◽  
Author(s):  
Robert B Bolash ◽  
Pavan Tankha
Keyword(s):  
Nerve Root ◽  
Cervical Spondylosis ◽  
Cervical Vertebrae ◽  
Cervical Radiculopathy ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Clinical Correlates ◽  
Arm Pain ◽  
Red Flag ◽  
Interventional Therapies

Cervical radiculopathy refers to injury or compression to the cervical nerve root(s) that results in pain and/or numbness distribution of the nerve. Clinically, patients present with neck and/or arm pain and numbness in the concordant dermatomes or myotomes. In the absence of “red flag” symptoms, treatment consists of conservative, medical, and interventional therapies. This review covers the epidemiology and etiology, pathophysiology and pathogenesis, diagnosis, treatment, and prognosis of cervical radiculopathy. The figure shows the cervical vertebrae and associated neural elements. Tables list the “red flag” symptoms suggesting prompt evaluation, clinical correlates among patients with cervical radiculopathy, and the differential diagnosis of cervical radiculopathy. This review contains 1 figure, 3 tables, and 33 references. Key words: C7 nerve root, cervical nerve compression, cervical nerve injury, cervical nerve root, cervical radiculopathy, cervical spondylosis, neck pain 

Cervical Radiculopathy

2018 ◽  
Author(s):  
Robert B Bolash ◽  
Pavan Tankha
Keyword(s):  
Nerve Root ◽  
Cervical Spondylosis ◽  
Cervical Vertebrae ◽  
Cervical Radiculopathy ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Clinical Correlates ◽  
Arm Pain ◽  
Red Flag ◽  
Interventional Therapies

Cervical radiculopathy refers to injury or compression to the cervical nerve root(s) that results in pain and/or numbness distribution of the nerve. Clinically, patients present with neck and/or arm pain and numbness in the concordant dermatomes or myotomes. In the absence of “red flag” symptoms, treatment consists of conservative, medical, and interventional therapies. This review covers the epidemiology and etiology, pathophysiology and pathogenesis, diagnosis, treatment, and prognosis of cervical radiculopathy. The figure shows the cervical vertebrae and associated neural elements. Tables list the “red flag” symptoms suggesting prompt evaluation, clinical correlates among patients with cervical radiculopathy, and the differential diagnosis of cervical radiculopathy. This review contains 1 figure, 3 tables, and 33 references. Key words: C7 nerve root, cervical nerve compression, cervical nerve injury, cervical nerve root, cervical radiculopathy, cervical spondylosis, neck pain 

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