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A technical case report on use of tubular retractors for anterior cervical spine surgery

European Spine Journal volume 27, pages 1454–1459 (2018)Cite this article

Abstract

Purpose

The authors put-forth this technical report to establish the feasibility of performing an anterior cervical corpectomy and fusion (ACCF) and a two-level anterior cervical discectomy and fusion (ACDF) using a minimally invasive approach with tubular retractors.

Methods

First case: cervical spondylotic myelopathy secondary to a large postero-inferiorly migrated disc treated with corpectomy and reconstruction with a mesh cage and locking plate. Second case: cervical disc herniation with radiculopathy treated with a two-level ACDF. Both cases were operated with minimally invasive approach with tubular retractor using a single incision. Technical aspects and clinical outcomes have been reported.

Results

No intra or post-operative complications were encountered. Intra-operative blood loss was negligible. The patients had a cosmetic scar on healing. Standard procedure of placement of tubular retractors is sufficient for adequate surgical exposure with minimal invasiveness.

Conclusion

Minimally invasive approach to anterior cervical spine with tubular retractors is feasible. This is the first report on use of minimally invasive approach for ACCF and two-level ACDF.

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References

  1. Buttermann GR (2008) Prospective nonrandomized comparison of an allograft with bone morphogenic protein versus an iliac-crest autograft in anterior cervical discectomy and fusion. Spine J 8:426–435

    Article  PubMed  Google Scholar 

  2. Campbell PG, Yadla S, Malone J et al (2010) Early complications related to approach in cervical spine surgery: single-centre prospective study. World Neurosurg 74:363–368

    Article  PubMed  Google Scholar 

  3. Kalb S, Reis MT, Cowperthwaite MC et al (2012) Dysphagia after anterior cervical spine surgery: incidence and risk factors. World Neurosurg 77:183–187

    Article  PubMed  Google Scholar 

  4. Ghogawala Z, Coumans JV, Benzel EC et al (2007) Ventral versus dorsal decompression for cervical spondylotic myelopathy: surgeons’ assessment of eligibility for randomization in a proposed randomized controlled trial: results of a survey of the Cervical Spine Research Society. Spine 32:429–436

    Article  PubMed  Google Scholar 

  5. Raj DR, Krishnaj G, Kenny S (2006) Operative treatment of cervical spondylotic myelopathy. J Bone Jt Surg Am 88:1619–1640

    Article  Google Scholar 

  6. Silber JS, Anderson DG, Daffner SD et al (2003) Donor site morbidity after anterior iliac crest bone harvest for single-level anterior cervical discectomy and fusion. Spine 28:134–139

    Article  PubMed  Google Scholar 

  7. Song Kyung-Jin, Lee Kwang-Bok, Song Ji-Hoon (2012) Efficacy of multilevel anterior cervical discectomy and fusion versus corpectomy and fusion for multilevel cervical spondylotic myelopathy: a minimum 5-year follow-up study. Eur Spine J 21:1551–1557

    Article  PubMed  PubMed Central  Google Scholar 

  8. Hershman Stuart H, Kunkle William A, Kelly Michael P et al (2017) Oesophageal perforation following anterior cervical spine surgery: case report and review of the literature. Glob Spine J 7(1S):28S–36S

    Article  Google Scholar 

  9. Halani Sameer H, Baum Griffin R, Riley Jonathan P et al (2016) Oesophageal perforation after anterior cervical spine surgery: a systematic review of the literature. J Neurosurg Spine 25:285–291

    Article  PubMed  Google Scholar 

  10. Riley LH, Skolasky Richard L, Albert Todd J et al (2005) Dysphagia after anterior cervical decompression and fusion prevalence and risk factors from a longitudinal cohort study. Spine 30(22):2564–2569

    Article  PubMed  Google Scholar 

  11. Yao Nuzhao, Wang Cheng (2011) Full-endoscopic technique for anterior cervical discectomy and interbody fusion: 5-year follow-up results of 67 cases. Eur Spine J 20:899–904

    Article  PubMed  Google Scholar 

  12. Saringer WF, Reddy B, Nobauer-Huhmann I et al (2003) Endoscopic anterior cervical foraminotomy for unilateral radiculopathy: anatomical morphometric analysis and preliminary clinical experience. J Neurosurg 98(Suppl 2):171–180

    PubMed  Google Scholar 

  13. Amendola Luca, Cappuccio Michele (2013) Endoscopic excision of C2 osteoid osteoma: a technical case report. Eur Spine J 22(Suppl 3):S357–S362

    Article  PubMed  Google Scholar 

  14. Baba H, Furusawa N, Tanaka Y et al (1994) Anterior decompression and fusion for cervical myelo-radiculopathy secondary to ossification of the posterior ligament. Int Orthop 18:204–209

    PubMed  CAS  Google Scholar 

  15. Fontanella A (1999) Endoscopic microsurgery in herniated cervical discs. Neurol Res 21:31–38

    Article  PubMed  CAS  Google Scholar 

  16. Ono K, Ebara S, Fuji T et al (1987) Myelopathy hand. New clinical signs of cervical cord damage. J Bone Jt Surg Br 69:215–219

    Article  CAS  Google Scholar 

  17. Kulkarni Arvind G, Dhruv Abhilash N, Bassi Anupreet (2012) Microendoscopic excision of C2 osteoid osteoma; a technical report. Spine 38(19):E1231–E1234

    Article  Google Scholar 

  18. Frempong-Boadu A, Houten JK, Osborn B et al (2002) Swallowing and speech dysfunction in patients undergoing anterior cervical discectomy and fusion: a prospective, objective preoperative and postoperative assessment. J Spinal Disord Tech 15:362–368

    Article  PubMed  Google Scholar 

  19. Tervonen H, Niemela M, Lauri ER et al (2007) Dysphonia and dysphagia after anterior cervical decompression. J Neurosurg Spine 7:124–130

    Article  PubMed  Google Scholar 

  20. Ratnaraj J, Todorov A, McHugh T et al (2002) Effects of decreasing endotracheal tube cuff pressures during neck retraction for anterior cervical spine surgery. J Neurosurg 97:176–179

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopedics and Spine Surgery, Mumbai Spine Scoliosis and Disc Replacement Center, Bombay Hospital and Medical Research Center, Room No-206, Marine Lines, Mumbai, 400002, India

    Arvind G. Kulkarni, Ankit Patel & N. V. Ankith

Authors
  1. Arvind G. Kulkarni
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  2. Ankit Patel
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  3. N. V. Ankith
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Correspondence to Arvind G. Kulkarni.

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The authors declare that they have no competing interests.

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Kulkarni, A.G., Patel, A. & Ankith, N.V. A technical case report on use of tubular retractors for anterior cervical spine surgery. Eur Spine J 27, 1454–1459 (2018). https://doi.org/10.1007/s00586-017-5423-x

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  • DOI: https://doi.org/10.1007/s00586-017-5423-x

Keywords

  • Tubular retractors
  • Cervical spine
  • Minimal invasive spine surgery
  • Anterior cervical discectomy and fusion
  • Spinal fusion