Keyhole approach for posterior cervical discectomy: Experience on 84 patients


ÇAĞLAR Y. Ş., Bozkurt M., Kahilogullari G., Tuna H., Bakir A., Torun F., ...More

MINIMALLY INVASIVE NEUROSURGERY, vol.50, no.1, pp.7-11, 2007 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 50 Issue: 1
  • Publication Date: 2007
  • Doi Number: 10.1055/s-2007-970138
  • Journal Name: MINIMALLY INVASIVE NEUROSURGERY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.7-11
  • Keywords: cervical radiculopathy, disc herniation, keyhole, anatomy, RADICULOPATHY, FORAMINOTOMY, SPINE, DISC, LAMINOFORAMINOTOMY, FUSION
  • Ankara University Affiliated: Yes

Abstract

Anterior cervical discectomy with or without fusion has been commonly used for cervical disc disease since the description by Smith and Robinson in 1958. In this report, surgical technique, advantages, and disadvantages of the posterior approach, known as the posterior keyhole laminotomy-foraminotomy, are reviewed and motion versus fusion surgery discussed. Between 1996 and 2004, the keyhole laminotomy-foraminotomy was performed on 84 patients suffering from lateral cervical soft disc herniation or osteophytes. All the procedures were performed under the surgical microscope. A high-speed drill was used for drilling the bone. In 49 patients (58%), soft disc herniation was removed, while in 35 patients (42%) there were osteophytes. Successful relief of radiculopathy symptoms was achieved in 80 patients (96%). In 4 patients the symptoms recurred. One patient (1.2%) developed kyphosis. The only complication observed intraoperatively was a partial root injury in one patient (1.2%). Mean hospitalization time was 48 hours. The posterior approach is particularly appropriate in patients whose root compression is located postero laterally. Advantages of this surgery are minimal lamina resection, good visualization of the nerve root, postoperative early mobilization and minimal hospitalization. Microsurgery enables us to both preserve the motion of operated segment and avoid cervical instability.