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Posterior Cervical Decompression

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Minimally Invasive Spine Surgery

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Abstract

Posterior cervical decompression is an effective technique for the treatment of cervical radiculopathy from various sources of central and foraminal stenosis such as herniated nucleus pulposus, osteophytes, and other degenerative changes. For the surgical treatment of cervical radiculopathy, options include both anterior and posterior procedures. Posterior decompressive procedures have the advantage of preserving motion and decreasing the long-term sequelae of anterior fusions such as adjacent segment degeneration. Posterior cervical decompressive procedures also avoid the approach-related complications of anterior procedures such as esophageal injury, vascular injury, recurrent laryngeal nerve paralysis, and postoperative dysphagia.

Minimally invasive posterior surgical techniques have recently been developed to mitigate the extensive stripping of paraspinal musculature necessary in open posterior cervical approaches which can result in significant postoperative pain or muscle spasm. Clinical results of minimally invasive posterior cervical foraminotomy have shown equivalent efficacy with a reduction in blood loss, length of stay, and postoperative pain compared to open surgery. Minimally invasive foraminotomy has also been shown to achieve equivalent decompression compared to open techniques in cadaveric models and shown to require less surgical time than an anterior cervical discectomy and fusion. This chapter will review the technique of posterior cervical decompression using a minimally invasive tubular retractor system.

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Author information

Authors and Affiliations

  1. The Orthopedic Sports Clinic, Nobilis Health Corporation, Houston, TX, USA

    Neil M. Badlani

  2. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA

    Frank M. Phillips

Authors
  1. Neil M. Badlani
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  2. Frank M. Phillips
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Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA

    Frank M. Phillips

  2. Texas Back Institute Texas Health Presbyterian Hospital Plano Scoliosis and Spine Tumor Center, Plano, TX, USA

    Isador H. Lieberman

  3. Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA

    David W. Polly Jr.

  4. Department of Neurological Surgery, University of Miami/Jackson Memorial Hospital, Miami, FL, USA

    Michael Y. Wang

Appendices

Quiz Questions

  1. 1.

    The best indication for an MIS posterior cervical decompression is?

    1. (a)

      Cervical spondylosis with axial neck pain

    2. (b)

      Lateral disc herniation causing cervical radiculopathy

    3. (c)

      Severe central stenosis causing cervical myelopathy

    4. (d)

      None of the above

  2. 2.

    Appropriate technique for decompression follows which step-by-step approach?

    1. (a)

      Partial resection of superior facet, partial resection of inferior facet, laminotomy, use of nerve hook for disc fragment removal

    2. (b)

      Laminotomy, partial resection of superior facet, partial resection of inferior facet, use of nerve hook for disc fragment removal

    3. (c)

      Laminotomy, partial resection of inferior facet, partial resection of superior facet, use of nerve hook for disc fragment removal

    4. (d)

      Laminotomy, use of nerve hook for disc fragment removal, complete resection of facet

Answers

  1. 1.

    b

  2. 2.

    c

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Badlani, N.M., Phillips, F.M. (2019). Posterior Cervical Decompression. In: Phillips, F., Lieberman, I., Polly Jr., D., Wang, M. (eds) Minimally Invasive Spine Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-19007-1_14

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  • DOI: https://doi.org/10.1007/978-3-030-19007-1_14

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-19006-4

  • Online ISBN: 978-3-030-19007-1

  • eBook Packages: MedicineMedicine (R0)

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