scholarly journals Decompression via microsurgical anterior foraminotomy for cervical spondylotic myelopathy

1996 ◽  
Vol 1 (6) ◽  
pp. E6 ◽  
Author(s):  
Hae-Dong Jho
Keyword(s):  
Spinal Cord ◽  
Surgical Technique ◽  
Nerve Root ◽  
Cervical Spondylotic Myelopathy ◽  
Anterior Approach ◽  
Fast Recovery ◽  
The Past ◽  
Spinal Cord Decompression ◽  
New Surgical Technique ◽  
Uncovertebral Joint

Over the past few years, a microsurgical anterior foraminotomy technique has been developed by the author and used to achieve spinal cord decompression for the treatment of cervical spondylotic myelopathy. A 5 X 8-mm unilateral anterior foraminotomy is accomplished by resecting the uncovertebral joint via an anterior approach. Through the foraminotomy hole, the posterior osteophytes at the spinal cord canal are removed diagonally up to the beginning of the contralateral nerve root. To treat multilevel disease, a tunnel is made among the foraminotomy holes. This technique accomplishes widening of the spinal cord canal in the transverse and longitudinal axes by direct resection of the compressive lesions through the holes of unilateral anterior foraminotomies; however, it does not require bone fusion or postoperative immobilization. Postoperatively patients remain in the hospital overnight, and do not need to wear cervical braces. This new surgical technique has shown excellent clinical outcomes with fast recovery and adequate anatomical decompression in patients with cervical spondylotic myelopathy. The surgical technique is reported and illustrated by two of the author's cases.

Decompression via microsurgical anterior foraminotomy for cervical spondylotic myelopathy

1997 ◽  
Vol 86 (2) ◽  
pp. 297-302 ◽  
Author(s):  
Hae-Dong Jho
Keyword(s):  
Spinal Cord ◽  
Surgical Technique ◽  
Cervical Spondylotic Myelopathy ◽  
Anterior Approach ◽  
Fast Recovery ◽  
Content Type ◽  
The Past ◽  
Spinal Cord Decompression ◽  
New Surgical Technique ◽  
Uncovertebral Joint

✓ Over the past few years, a microsurgical anterior foraminotomy technique has been developed by the author and used to achieve spinal cord decompression for the treatment of cervical spondylotic myelopathy. A 5 × 8—mm unilateral anterior foraminotomy is accomplished by resecting the uncovertebral joint via an anterior approach. Through the foraminotomy hole, the posterior osteophytes at the spinal cord canal are removed diagonally up to the beginning of the contralateral nerve root. To treat multilevel disease, a tunnel is made among the foraminotomy holes. This technique accomplishes widening of the spinal cord canal in the transverse and longitudinal axes by direct resection of the compressive lesions through the holes of unilateral anterior foraminotomies; however, it does not require bone fusion or postoperative immobilization. Postoperatively patients remain in the hospital overnight, and do not need to wear cervical braces. This new surgical technique has shown excellent clinical outcomes with fast recovery and adequate anatomical decompression in patients with cervical spondylotic myelopathy. The surgical technique is reported and illustrated by two of the author's cases.

scholarly journals Severe Cervical Spinal Kyphosis: Technical Case Reports on the Way of Microsurgical Management

2020 ◽  
Vol 3 (1) ◽  
pp. 1-9
Author(s):  
Forhad H. Chowdhury ◽  
Mohammod Raziul Haque
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Neurological Deficit ◽  
Anterior Approach ◽  
Case Reports ◽  
Posterior Stabilization ◽  
Cervical Corpectomy ◽  
Transforaminal Approach ◽  
Partial Corpectomy ◽  
Spinal Cord Decompression

A young man presented with quadriparesis due to severe kyphosis of the cervical spine. In the first posterior operation, the spinal cord was decompressed by laminectomies and posterior partial corpectomy through bilateral translateral mass and transforaminal approach followed by posterior stabilization and fusion. In the second operation, the cervical spine was stabilized and fused through an anterior approach. The patient recovered completely from his neurological deficit with very minimal neck movements. We report this case to describe the bilateral translateral mass and transforaminal partial posterior cervical corpectomy for spinal cord decompression followed by posterior and anterior stabilization and fusion.

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.

scholarly journals Comparison of anterior and posterior surgical approaches in multi-level cervical spondylotic myelopathy

2021 ◽  
Vol 8 (8) ◽  
pp. 2371
Author(s):  
Paruvakkattil Kunjan Balakrishnan ◽  
Tinu R. Abraham ◽  
Ajax John
Keyword(s):  
Spinal Cord ◽  
Cervical Spondylotic Myelopathy ◽  
Anterior Approach ◽  
Surgical Approaches ◽  
Decompression Surgery ◽  
Japanese Orthopedic Association ◽  
Spinal Cord Level ◽  
Multi Level ◽  
Multilevel Cervical Spondylotic Myelopathy ◽  
Operative Assessment

Background: Cervical spondylotic myelopathy (CSM) is one of the most common dysfunctions of spinal cord which occurs due to degenerative changes in cervical spine disc and facet joints. The management of multilevel spondylotic myelopathy is always controversial. The posterior approaches are always preferable in multiple level spondylosis. But according to newer studies, anterior approaches have similar results. Aim of the study was to compare the efficacy of posterior and anterior approaches in multilevel cervical myelopathy.Methods: This study includes all patients with multilevel cervical spondylotic myelopathy who have undergone decompression surgery with fusion. Detailed preoperative and post-operative assessment was done according to modified Japanese Orthopedic Association scoring system.Results: Eighty eight patients of CSM surgical cases were selected for this study and 29 cases of multi-level CSM were observed. And they were randomly selected for anterior and posterior approaches. Sixteen cases anterior approach was done either ACDF or Corpectomy with fusion. Mean age of study was 51.63 years with 64 males and 24 females. The spinal cord level at which most surgeries did was C5/6, 62 cases. While at level C4/5, it was 49 and at level C3/4 and C6/7, it was 35 and 36 respectively.Conclusions: Both anterior approach and posterior approaches were associated with betterment in postoperative neurological function for multilevel CSM. And there is no significant advantage in doing anterior approach in multilevel CSM.

scholarly journals ObliqueCorpectomyto Manage Cervical Myeloradiculopathy

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Chibbaro Salvatore ◽  
Makiese Orphee ◽  
Bresson Damien ◽  
Reiss Alisha ◽  
Poczos Pavel ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Surgical Technique ◽  
Posterior Longitudinal Ligament ◽  
Lateral Approach ◽  
Lateral Part ◽  
Lateral Aspect ◽  
Oblique Corpectomy ◽  
Physiological Motion ◽  
Uncovertebral Joint

Background. The authors describe a lateral approach to the cervical spine for the management of spondylotic myeloradiculopathy. The rationale for this approach and surgical technique are discussed, as well as the advantages, disadvantages, complications, and pitfalls based on the author's experience over the last two decades.Methods. Spondylotic myelo-radiculopathy may be treated via a lateral approach to the cervical spine when there is predominant anterior compression associated with either spine straightening or kyphosis, but without vertebral instability.Results. By using a lateral approach, the lateral aspect of the cervical spine and the vertebral artery are easily reached and visualized. Furthermore, the lateral part of the affected intervertebral disc(s), uncovertebral joint(s), vertebral body(ies), and posterior longitudinal ligament can be removed as needed to decompress nerve root(s) and/or the spinal cord.Conclusion. Multilevel cervical oblique corpectomy and/or lateral foraminotomy allow wide decompression of nervous structures, while maintaining optimal stability and physiological motion of the cervical spine.

scholarly journals Recent advances in the management of cervical spondylotic myelopathy: bibliometric analysis and surgical perspectives

2019 ◽  
Vol 31 (3) ◽  
pp. 299-309 ◽  
Author(s):  
Yu-Chun Chen ◽  
Chao-Hung Kuo ◽  
Chieh-Ming Cheng ◽  
Jau-Ching Wu
Keyword(s):  
Spinal Cord ◽  
Cervical Spondylotic Myelopathy ◽  
Diagnosis And Treatment ◽  
Optimal Timing ◽  
Asian Countries ◽  
The Past ◽  
Recent Advances ◽  
Number Of Patients ◽  
Pubmed Database ◽  
Cord Injury

OBJECTIVECervical spondylotic myelopathy (CSM) has become a prevalent cause of spinal cord dysfunction among the aging population worldwide. Although great strides have been made in spine surgery in past decades, the optimal timing and surgical strategy to treat CSM have remained controversial. In this article the authors aimed to analyze the current trends in studies of CSM and to summarize the recent advances of surgical techniques in its treatment.METHODSThe PubMed database was searched using the keywords pertaining to CSM in human studies that were published between 1975 and 2018. Analyses of both the bibliometrics and contents, including the types of papers, authors, affiliations and countries, number of patients, and the surgical approaches were conducted. A systematic review of the literature was also performed with emphasis on the diagnosis and treatment of mild CSM.RESULTSA total of 1008 papers published during the span of 44 years were analyzed. These CSM studies mainly focused on the natural history, diagnosis, and treatment, and only a few prospective randomized trials were reported. For the authors and affiliations, there was a shift of clustering of papers toward Asian countries in the past decades. Regarding the treatment for CSM, there was an exponential growth of surgical series published, and there was a trend toward slightly more anterior than posterior approaches through the past decade. Patients with CSM had increased risks of neurological deterioration or spinal cord injury with nonoperative management. Because surgery might reduce the risks, and early surgery was likely to be correlated with better outcomes, there was a trend toward attention to mildly symptomatic CSM.CONCLUSIONSThere is emerging enthusiasm for research on CSM worldwide, with more publications originating in Asian countries over the past few decades. The surgical management of CSM is evolving continuously toward early and anterior approaches. More prospective investigations on the optimal timing and choices of surgery are therefore needed.

A simple surgical technique for correcting malunion after midshaft clavicle fracture

2020 ◽  
pp. 175857322093324
Author(s):  
Tom van Essen ◽  
Robert Jan Hillen
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Clavicle Fracture ◽  
Treatment Modalities ◽  
Shoulder Dysfunction ◽  
The Past ◽  
Clavicle Fractures ◽  
New Surgical Technique

Clavicle malunion occurs in two-thirds of all clavicle fractures treated conservatively. It can lead to pain, shoulder dysfunction and cosmetic complaints. Surgical treatment of all midshaft fractures will lead to overtreatment, as not all malunions are symptomatic. In the past, several treatment modalities for correcting malunion of the clavicle have been described, and all have been successful but none have shown superiority. This article describes a new surgical technique with excising a wedge to realign the clavicle malunion.

scholarly journals Microendoscopic decompression for cervical spondylotic myelopathy

2013 ◽  
Vol 35 (1) ◽  
pp. E8 ◽  
Author(s):  
Nader S. Dahdaleh ◽  
Albert P. Wong ◽  
Zachary A. Smith ◽  
Ricky H. Wong ◽  
Sandi K. Lam ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Retrospective Study ◽  
Cobb Angle ◽  
Cervical Spondylotic Myelopathy ◽  
Elderly Population ◽  
The Elderly ◽  
The Mean ◽  
Spinal Cord Decompression ◽  
Cervical Degenerative Disease

Object Cervical spondylotic myelopathy (CSM) is a common cervical degenerative disease that affects the elderly population. Spinal cord decompression is achieved through various anterior and posterior approaches including anterior cervical decompression and fusion, laminectomy, laminoplasty, and combined approaches. The authors describe another option, minimally invasive endoscopically assisted decompression of stenosis (MEDS), which obviates the need for muscle dissection and disruption of the posterior tension band, a cause of postlaminectomy kyphosis. Methods The authors conducted a retrospective study of 10 patients with CSM who underwent MEDS from January 2002 through July 2012. Data were collected on demographics, preoperative and postoperative Nurick scores, postoperative Odom scores, and preoperative and postoperative Cobb angles. Results The mean patient age (± SD) was 67 ± 7.7 years; 8 patients were male. The average number of disc levels operated on was 2.2 (range 1–4). The mean Nurick score was 1.6 ± 0.7 preoperatively and improved to 0.3 ± 0.7 postoperatively (p < 0.0005). The postoperative Odom scores indicated excellent outcomes for 4 patients, good for 3, fair for 2, and poor for 1. The average preoperative focal Cobb angle at the disc levels operated on was −0.43º ± 1.9º. The average Cobb angle at the last follow-up visit was 0.25° ± 1.6° (p = 0.6). The average follow-up time was 18.9 ± 32.1 months. There were no intraoperative or postoperative complications. Conclusions For selected patients with CSM, whose pathologic changes are primarily posterior and who have acceptable preoperative lordosis, MEDS is an alternative to open laminectomy and laminoplasty.

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