Abstract
Background
Cervical radiculopathy from uncovertebral joint hypertrophy and foraminal stenosis is a common indication for anterior cervical diskectomy and fusion (ACDF). Often, the uncinate hypertrophy extends lateral to the foramen and impinges on the nerve close to the vertebral artery as it travels in between the transverse foramina.
Method
Using an injected cadaveric specimen to highlight the vital neurovascular and bony structures pertinent to this procedure, we demonstrate the technical details of complete uncinatectomy for cervical foraminal stenosis.
Conclusion
Total uncinatectomy is a useful adjunct during ACDF for complete foraminal decompression in cases of uncovertebral joint hypertrophy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bruneau M, Cornelius JF, Marneffe V, Triffaux M, George B (2006) Anatomical variations of the V2 segment of the vertebral artery. Neurosurgery 59:ONS20–ONS24; discussion ONS20-24. https://doi.org/10.1227/01.Neu.0000219931.64378.B5
Fountas KN, Kapsalaki EZ, Nikolakakos LG, Smisson HF, Johnston KW, Grigorian AA, Lee GP, Robinson JS Jr (2007) Anterior cervical discectomy and fusion associated complications. Spine 32:2310–2317. https://doi.org/10.1097/BRS.0b013e318154c57e
Hartman J (2014) Anatomy and clinical significance of the uncinate process and uncovertebral joint: a comprehensive review. Clin Anat (New York, NY) 27:431–440. https://doi.org/10.1002/ca.22317
Kaiser MG, Haid RW Jr, Subach BR, Barnes B, Rodts GE Jr (2002) Anterior cervical plating enhances arthrodesis after discectomy and fusion with cortical allograft. Neurosurgery 50:229–236 discussion 236-228
Rhee JM, Yoon T, Riew KD (2007) Cervical radiculopathy. J Am Acad Orthop Surg 15:486–494
Tan LA, Riew KD (2018) Anterior cervical foraminotomy: 2-dimensional operative video. Oper Neurosur (Hagerstown, Md) 15:E66. https://doi.org/10.1093/ons/opy071
Tan LA, Riew KD, Traynelis VC (2017) Cervical spine deformity-part 1: biomechanics, radiographic parameters, and classification. Neurosurgery 81:197–203. https://doi.org/10.1093/neuros/nyx249
Tubbs RS, Rompala OJ, Verma K, Mortazavi MM, Benninger B, Loukas M, Chambers MR (2012) Analysis of the uncinate processes of the cervical spine: an anatomical study. J Neurosurg Spine 16:402–407. https://doi.org/10.3171/2011.12.Spine11541
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflicts of interest.
Informed consent
This article does not contain any studies with human participants performed by any of the authors.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This article is part of the Topical Collection on Neurosurgical Anatomy
Electronic supplementary material
Video 1.
Preoperative considerations, operative technique, and vital neurovascular anatomy pertaining to total anterior cervical uncinatectomy with diskectomy are highlighted in this video by use of an injected cadaveric specimen. (M4V 56531 kb).
Rights and permissions
About this article
Cite this article
Clifton, W., Williams, D. & Pichelmann, M. How I do it: total uncinatectomy during anterior diskectomy and fusion for cervical radiculopathy caused by uncovertebral joint hypertrophy. Acta Neurochir 161, 2229–2232 (2019). https://doi.org/10.1007/s00701-019-04033-w
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00701-019-04033-w