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Lateral Approach to the Cervical Spine to Manage Degenerative Cervical Myelopathy and Radiculopathy

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The Funnel: From the Skull Base to the Sacrum

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 135))

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Abstract

Background: The cervical lateral approach can enlarge the spinal canal and foramen to achieve an effective neural decompression without needing spine stabilization. For this review, the authors’ main objective was to illustrate the rationale, advantages, disadvantages, complications, and pitfalls of this technique, highlighting also areas for future development.

Materials and Methods: A Medline via PubMed database search was carried out by using both keywords, namely “cervical oblique corpectomy,” “multilevel oblique corpectomy and foraminotomy,” and “lateral vertebrectomy,” and Medical Subject Headings (MeSH) terms from 1 January 1991, up to 31 December 2021.

Results: The analyzed articles suggested that the use of such a technique has declined over time; only 29 clinical studies met all the inclusion criteria and were retained for data analysis, including 1200 patients undergoing such an approach for the management of degenerative cervical myelopathies (DCMs) or of radiculopathies. The main etiopathogeneses were cervical stenosis, degenerative disk disease, or a mix of them—78% of which had a favorable outcome; the most frequent complications were transient and permanent Horner syndrome in 13.6% and 9.2% of cases, respectively. Long-term stability was reported in 97% of patients.

Conclusion: Multilevel cervical oblique vertebrectomy and/or lateral foraminotomy allow wide neural structure decompression and optimal stability given that the physiological spinal motion is preserved.

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Conflict of Interest

The authors declare that they have no competing financial interests or personal relationships that could have appeared to influence the work reported in this chapter.

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Authors and Affiliations

  1. Department of Neurosurgery, Strasbourg University Hospital, Strasbourg, France

    S. Chibbaro, C. H. Mallereau, I. Zaed, J. Todeschi & M. Ganau

  2. Department of Neurosurgery, Duesseldorf University Hospital, Duesseldorf, Germany

    J. F. Cornelius

  3. Department of Neurosurgery, UZ Hospital Brussel, Jette, Belgium

    M. Bruneau

  4. Department of Neurosurgery, Catholic University of Rome, Rome, Italy

    M. Visocchi

  5. Genolier Spine Care Center, Swiss Medical Network, Genolier, Switzerland

    R. Maduri

  6. Department of Neurosurgery, Andria Bonomo Hospital, Andria, Italy

    C. Bruno

  7. Department of Neurosurgery, Lariboisiere University Hospital, Paris, France

    B. George & S. Froelich

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  1. Institute of Neurosurgery, Catholic University of Rome, Rome, Italy

    Massimiliano Visocchi

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Chibbaro, S. et al. (2023). Lateral Approach to the Cervical Spine to Manage Degenerative Cervical Myelopathy and Radiculopathy. In: Visocchi, M. (eds) The Funnel: From the Skull Base to the Sacrum. Acta Neurochirurgica Supplement, vol 135. Springer, Cham. https://doi.org/10.1007/978-3-031-36084-8_51

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  • DOI: https://doi.org/10.1007/978-3-031-36084-8_51

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