Surgical Techniques Ensuring Success in Posterior Endoscopic Cervical Foraminotomy and Discectomy at C6-7 in Patients with Prominent Shoulders and Short Necks

2021 ◽  
Author(s):  
Kaixuan Liu ◽  
Praveen Kadimcherla
Keyword(s):  
Disc Herniation ◽  
Surgical Techniques ◽  
Cervical Radiculopathy ◽  
The Novel ◽  
Anatomic Site ◽  
Study Objective ◽  
Steep Learning Curve ◽  
Arm Pain ◽  
Foraminal Disc Herniation ◽  
Cervical Foraminotomy

Introduction: There is a steep learning curve for a successful posterior endoscopic cervical foraminotomy and discectomy (PECFD), an important surgery for cervical foraminal or lateral disc herniation, and cervical radiculopathy due to a small operation field. PECFD becomes even more challenging in patients who have prominent shoulders and/or short necks with C6–7-disc herniation, because of the difficulty to localize C6–7 vertebral structure under fluoroscopy. The study objective is to prove that the PECFD can be performed safely and successfully to C6–7-disc herniation on patients with prominent shoulders and/or short necks following our novel surgical techniques under fluoroscopic guidance. Materials and Methods: PECFD was performed on a patient who had an extruded foraminal disc herniation at C6–7 on the left with left arm pain and weakness. Due to his prominent shoulders and a short neck, the C6–7 anatomic site was not visible under traditional anterior-posterior (AP) and lateral fluoroscopic views. The authors inserted a reference needle to C4–5 facets between C4 and C5 pedicles under AP and lateral fluoroscopic views. Following the reference needle, the C6–7 facets were easily located with an oblique fluoroscopic view. A large endoscopic cannula was used initially for adequate resection of C6–7 facets, followed by a small cannula for nerve root handling with minimal pressure and discectomy. Results: The novel surgical techniques resulted in a complete resection of the C6–7-disc herniation and resolution of the patient’s radiculopathy with no postoperative complications. Conclusion: PECFD can be safely and successfully applied for C6–7-disc herniation in patients with prominent shoulders and/or short necks using our novel surgical techniques.

scholarly journals Minimally Invasive Full-Endoscopic Posterior Cervical Foraminotomy Assisted by O-Arm-Based Navigation

2018 ◽  
Vol 1 (21;1) ◽  
pp. E217-E223
Author(s):  
Yue Zhou
Keyword(s):  
Minimally Invasive ◽  
Symptom Duration ◽  
Foraminal Stenosis ◽  
Arm Pain ◽  
Sf 36 ◽  
Posterior Cervical Foraminotomy ◽  
Invasive Method ◽  
Foraminal Disc Herniation ◽  
Cervical Foraminotomy

Background: Navigated percutaneous endoscopic cervical discectomy (PECD) is a promising minimally invasive surgery for treating cervical spondylotic radiculopathy. PECD has been described as a safe, effective, and minimally invasive method for patients with radiculopathy, but it comes with a steep learning curve. Due to the limited field of vision, anatomic localization is difficult for surgeons until using the O-arm based navigation. In this study, patients with radiculopathy due to foraminal disc herniation or foraminal stenosis in the lower cervical spine underwent the single level full endoscopic posterior cervical foraminotomy procedure assisted by O-arm-based navigation. Objective: The purpose of this study was to evaluate the clinical, radiological outcome and the factors predicting an excellent outcome of patients who underwent full endoscopic posterior cervical foraminotomy procedure assisted by O-arm-based navigation. Study Design: A retrospective analysis of consecutively prospectively collected data. Setting: This study was conducted by a university-affiliated hospital in a major Chinese city. Methods: Forty-two patients who had single-level foraminal disc herniation or foraminal stenosis were retrospectively reviewed. Radicular arm pain was the most common presenting symptom in patients. All patients underwent full-endoscopic posterior cervical foraminotomy assisted by O-arm-based navigation. Clinical outcomes were assessed by the visual analog scale (VAS) for neck and radicular arm pain, neck disability index (NDI), and the short form-36 health survey questionnaire (SF-36) in the immediate preoperative period, immediately postoperative, and at the final follow-up. The clinical parameters and radiological parameters included cervical curvature (CA), segmental angle (SA), and range of motion (ROM), which were assessed preoperatively and at the last follow-up. Results: The mean follow-up for the patients was 15 months. There were no perioperative complications. The VAS score for radicular arm pain and neck pain and the NDI score improved significantly in all of the patients. The SF-36 score reflected significant improvement in all 8 domains. Excellent and good outcomes were achieved in 38 out of 42 patients. The cervical curvature range of motion (CA-ROM) statistically and significantly improved at the final follow-up period compared with the preoperative period. The SA was less kyphotic after PECD at the final follow-up. The postoperative CA and CA-ROM improved but did not significantly change. On the univariate analysis, patients with a symptom duration of less than 3 months had a better outcome than patients with a symptom duration of more than 3 months (excellent, 83.33% vs. 50.00%). Limitations: This was a retrospective study with medium follow-up outcomes (mean 15 months). Conclusions: The results of this study show that the full endoscopic posterior foraminotomy assisted by O-arm-based navigation is a safe and effective option for cervical radiculopathy, with the advantages of a minimally invasive method. Patients with symptom duration less than 3 months had a better outcome than patients with symptom duration more than 3 months. Key words: Minimally invasive, cervical foraminotomy, endoscopic, navigation, O-arm, percutaneous endoscopic cervical discectomy

scholarly journals Full Endoscopic Posterior Cervical Foraminotomy in Management of Foraminal Disc Herniation and Foraminal Stenosis

2022 ◽  
Vol Volume 14 ◽  
pp. 1-7
Author(s):  
Asrafi Rizki Gatam ◽  
Luthfi Gatam ◽  
. Phedy ◽  
Harmantya Mahadhipta ◽  
Omar Luthfi ◽  
...  
Keyword(s):  
Disc Herniation ◽  
Foraminal Stenosis ◽  
Posterior Cervical Foraminotomy ◽  
Foraminal Disc Herniation ◽  
Cervical Foraminotomy

Radicular arm pain

2021 ◽  
pp. 1-10
Author(s):  
Surendra Patnaik ◽  
Alastair Carr ◽  
Praveen Inaparthy ◽  
Will KM Kieffer
Keyword(s):  
Surgical Techniques ◽  
Cervical Radiculopathy ◽  
Clinical Approach ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Arm Pain ◽  
Sensory Changes ◽  
Over Time ◽  
Careful History ◽  
Significant Weakness

Cervical radiculopathy is a neurological condition caused by dysfunction or compression of a cervical nerve root. Patients often report unilateral neck pain with radiation to the ipsilateral arm, often with sensory changes in a dermatomal distribution. Weakness and reflex changes are also commonly found and can be very troubling for patients. Careful history and examination is important to identify any more concerning features such as progressive symptoms and features of myelopathy, which could prompt surgical management. Although the majority of patients will see an improvement in their symptoms over time with conservative management, surgery is indicated in patients with debilitating pain, progressive neurology, significant weakness, instability or myelopathy. Advancements in surgical techniques offer a range of potential operations that should be considered carefully for each patient. This article outlines the clinical approach to presentation, pathophysiology, diagnosis and management.

Recurrence Rate of Lumbar Disc Herniation After Standard Discectomy and Microdiscectomy: A 5-Year Study

2019 ◽  
Vol 12 (2) ◽  
pp. 139-146
Author(s):  
Mladen E. Ovcharov ◽  
Iliya V. Valkov ◽  
Milan N. Mladenovski ◽  
Nikolay V. Vasilev
Keyword(s):  
Recurrence Rate ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Surgical Techniques ◽  
Reoperation Rate ◽  
University Hospital ◽  
Recurrence Rates ◽  
Chi Square ◽  
Common Procedure

Summary Lumbar disc herniation (LDH) is the most common pathology in young people, as well as people of active age. Despite sophisticated and new minimally invasive surgical techniques and approaches, reoperations for recurrent lumbar disc herniation (rLDH) could not be avoided. LDH recurrence rates, reported in different studies, range from 5 to 25%. The purpose of this study was to estimate the recurrence rates of LDH after standard discectomy (SD) and microdiscectomy (MD), and compare them to those reported in the literature. Retrospectively, operative reports for the period 2012-2017 were reviewed on LDH surgeries performed at the Neurosurgery Clinic of Dr Georgi Stranski University Hospital in Pleven. Five hundred eighty-nine single-level lumbar discectomies were performed by one neurosurgeon. The diagnoses of recurrent disc herniation were based on the development of new symptoms and magnetic resonance/computed tomography (MRI/CT) images showing compatible lesions in the same lumbar level as the primary lumbar discectomies. The recurrence rate was determined by using chi-square tests and directional measures. SD was the most common procedure (498 patients) followed by MD (91 patients). The cumulative reoperation rate for rLDH was 7.5%. From a total number of reoperations, 26 were males (59.1%) and 18 were females (40.9%). Reoperation rates were 7.6% and 6.6% after SD and MD respectively. The recurrence rate was not significantly higher for SD. Our recurrence rate was 7.5%, which makes it comparable with the rates of 5-25% reported in the literature.

scholarly journals A Transforaminal Endoscopic Surgical Technique for Treating Lumbar Disc Herniation in the Setting of Spina Bifida

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Albert E. Telfeian ◽  
Adetokunbo Oyelese ◽  
Jared Fridley ◽  
Rohaid Ali ◽  
Deus Cielo ◽  
...  
Keyword(s):  
Spina Bifida ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Recent Literature ◽  
Lumbar Disc ◽  
Surgical Techniques ◽  
Surgical Decompression ◽  
Minimally Invasive Approach ◽  
Disc Disease ◽  
Invasive Approach

Recent literature suggests that adult patients with spina bifida receive surgery for degenerative disc disease at higher rates than the general population. However, sometimes the complex anatomic features of co-occurring spina bifida and lumbar disc herniation can significantly challenge standard surgical techniques. Here, the technical steps are presented for treating a foraminal lumbar 4-5-disc herniation in the setting of a patient with multifaceted degenerative and spina bifida occulta anatomy. Utilized is a minimally invasive approach that does not require general anesthesia or fusion and allows the patient to leave the same day. To the best of our knowledge, this is the first-reported case of endoscopic surgical decompression of a lumbar disc in a patient with spina bifida.

Ambulatory Single-level Posterior Cervical Foraminotomy for Cervical Radiculopathy

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Patawut Bovonratwet ◽  
Julia S. Retzky ◽  
Aaron Z. Chen ◽  
Nathaniel T. Ondeck ◽  
Andre M. Samuel ◽  
...  
Keyword(s):  
Cervical Radiculopathy ◽  
Single Level ◽  
Posterior Cervical Foraminotomy ◽  
Cervical Foraminotomy

Clinical and Radiological Findings of Foraminal Disc Herniation

2005 ◽  
Vol 12 (2) ◽  
pp. 106
Author(s):  
Bo-Hyeon Kim ◽  
Dong-Soo Kim ◽  
Yong-Min Kim ◽  
Hyun-Chul Shon ◽  
Kyoung-Jin Park ◽  
...  
Keyword(s):  
Disc Herniation ◽  
Radiological Findings ◽  
Foraminal Disc Herniation

scholarly journals TRANSFORAMINAL CERVICAL NERVE ROOT BLOCK: OUTCOMES AND COMPLICATIONS

2016 ◽  
Vol 15 (3) ◽  
pp. 219-221 ◽  
Author(s):  
EMILIANO NEVES VIALLE ◽  
LUIZ ROBERTO GOMES VIALLE ◽  
JOANA BRETAS CABRAL RONDON GUASQUE
Keyword(s):  
Soft Tissue ◽  
Disc Herniation ◽  
Cervical Radiculopathy ◽  
Lateral Approach ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Transient Improvement ◽  
Cervical Nerve Root Block

ABSTRACT Objectives: To investigate the effect and complications after transforaminal injection for cervicobrachialgia caused by cervical disc herniation. Methods: We retrospectively reviewed all patients undergoing fluoroscopy-guided transforaminal injection for radiculopathy caused by cervical disc herniation. During the last seven years, 57 patients (39 female, 18 male, mean age 45.6 years) experiencing cervical radiculopathy underwent cervical foraminal block guided by fluoroscopy by postero-lateral approach. The position of the needle was verified after injection of a small amount of contrast. A glucocorticosteroid was injected after 0.5 ml of 2% lidocaine. Results: The local with the highest prevalence of procedures was C6 root (31 procedures); 14 patients underwent C7 block, 7 had C5 block, and 5 in C4. Eight patients (14%) had complications (3 syncopes, 3 transient hoarseness, one patient had worsening of symptoms and one patient had soft tissue hematoma). In total, 42.1% were asymptomatic after the procedure and therefore did not require surgery after the procedure. Other 57.9% had transient improvement, became asymptomatic for at least 2 months but required surgery due to the recurrence of symptoms. Conclusion: Cervical foraminal block for cervical disc herniation is a safe way to avoid surgery. Some patients still need surgery after the procedure, but the temporary improvement in symptoms gives the patient some relief while awaiting surgery.

scholarly journals Effect Of Cupping Massage and Modified Spinal Decompression Therapy With Exercise Therapy in Neck Radiculopathy Syndrome

2021 ◽  
Vol 12 (7) ◽  
pp. 340-348
Author(s):  
Al-Jazzazi, Saleem. Abdulmageed, Et. al.
Keyword(s):  
Disc Herniation ◽  
Lumbar Disc ◽  
Cervical Radiculopathy ◽  
New Method ◽  
Treatment Modalities ◽  
Cervical Disc ◽  
Spinal Decompression ◽  
Significant Difference ◽  
Cervical Traction ◽  
Lumbar Traction

Cervical radiculopathy Syndrome (CRS) is a common neuro-musculo-skeletal disorder causing pain and disability. Manual therapy interventions including cervical traction with other treatment modalities have been advocated to decrease pain and disability caused by cervical radiculopathy (CR). Al-Qudah & AL-Jazzazi (2021) conducted a new method of Spinal Decompression Therapy (SDT) in patients with Chronic Lumbar Disc Herniation (CLDH) which includes Combination of Lumbar Traction With Cervical Traction (CLTCT) as one intervention. Despite of that this new method clinically reduces pain and disability more effectively than the conventional types of Traction, CLTCT method was not previously used in CR patients nor with Cervical Disc Herniation (CDH). The clinical effectiveness of this new method with other treatment modalities in patients with CRS was not approved yet.  OBJECTIVE: The purpose of the presented work is to identify the effectiveness of rehabilitative program on patients with Cervical Radiculopathy, by (15) sessions for (4) Weeks. The suggested Rehabilitative program consisted of: 1.Supine Soft Full Back, Shoulders and Neck Cupping Massage (CM) for (10) minutes, 2.CLTCT: Combined Lumbar Traction with Cervical Traction as one intervention for (20) minutes, 3.Gradual Therapeutic Exercise Package of Neck Stretching and Strengthening Exercise for approximately (15) minutes. METHODS: In this study, Five outdoor male patients had accepted to participate  and were randomly chosen from Al-Karak Governmental Hospital, All subjects applied the proposed rehabilitative program. The results were analyzed using the SPSS system. RESULTS: indicates that there was statistically significant difference between the pre and post measurements in favor of the post measurements in terms of Pain, Disability. CONCLUSIONS: The present study demonstrated that the use of proposed rehabilitative program has a positive effect on patients with Cervical Radiculopathy.

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