Abstracts
Backgrounds: The most common treatment options for foraminal disc herniation and the resulting cervical spondylotic radiculopathy (CSR) are anterior cervical discectomy and fusion (ACDF), or laminoforaminotomy, which is accomplished posteriorly. However, these procedures are not without limitations or complications. In this regard, several reports have focused on the decompression of a cervical disc herniation or stenosis impinging on the cervical nerve root near or exiting the cervical intervertebral foramen through the vertebral transcorporeal route. However, their outcomes after these anterior cervical discectomy without fusion vary among the institutes.
Methods: After careful selection of the patients with isolated cervical soft disc herniation or focal osteophyte formation without instability, subluxation, malalignment, or loss of normal cervical lordosis, the number of the patients that required a delayed fusion procedure could be reduced to less than 1.5%. With these promising results from the literature, the authors have pursued direct removal of disc space pathology through transcorporeal route from the subjects that have met those selection criteria, leaving the majority of the anterior and central disc, anterior longitudinal ligament, and both upper and lower vertebral end plates intact.
Results: The crucial steps for this procedure include:
-
1.
Direct decompression of the offending compressive pathology as compared to an indirect decompression through the posterior approach
-
2.
Preservation of the cervical motion segment by avoiding violation of the facet joints
-
3.
Contained or limited end plate disruption in reaching the herniation
Conclusions: This selective removal procedure might exclude the fusion surgery-related complications while deterring the development of subsequent instability. Moreover, since it includes an “oblique” drilling procedure, this might also give a more free access to the region such as high cervical or cervicothoracic junction.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Benini A, Krayenbuhl H, Bruderl R. Anterior cervical discectomy without fusion. Microsurgical technique. Acta Neurochir. 1982;61:105–10.
Bertalanffy H, Eggert HR. Clinical long-term results of anterior discectomy without fusion for treatment of cervical radiculopathy and myelopathy. Acta Neurochir. 1988;90:127–35.
Martins AN. Anterior cervical discectomy with and without interbody bone graft. J Neurosurg. 1976;44:290–5.
Robertson JT. Anterior removal of cervical disc without fusion. Clin Neurosurg. 1973;20:259–61.
Hadley MN, Sonntag VK. Cervical disc herniations. The anterior approach to symptomatic interspace pathology. Neurosurg Clin N Am. 1993;4:45–52.
Skovrlj B, Gologorsky Y, Haque R, Fessler RG, Qureshi SA. Complications, outcomes, and need for fusion after minimally invasive posterior cervical foraminotomy and microdiscectomy. Spine J. 2014;14(10):2405–11.
Sakai T, Katoh S, Sairyo K, Tamura T, Hirohashi N, Higashino K, Yasui N. Anterior transvertebral herniotomy for cervical disc herniation: a long-term follow-up study. J Spinal Disord Tech. 2009;22(6):408–12.
Hong WJ, Kim WK, Park CW, Lee SG, Yoo CJ, Kim YB, Jho HD. Comparison between transuncal approach and upper vertebral transcorporeal approach for unilateral cervical radiculopathy - a preliminary report. Minim Invasive Neurosurg. 2006;49(5):296–301.
Kim MH. Clinical and radiological long-term outcomes of anterior microforaminotomy for cervical degenerative disease. Spine. 2013;38(21):1812–9.
Snyder GM, Bernhardt AM. Anterior cervical fractional interspace decompression for treatment of cervical radiculopathy. A review of the first 66 cases. Clin Orthop. 1989;246:92–9.
Hilibrand AS, Carlson GD, Palumbo MA, et al. Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am. 1999;81:519–28.
Choi G, Lee SH, Bhanot A, Chae YS, Jung B, Lee S. Modified transcorporeal anterior cervical microforaminotomy for cervical radiculopathy: a technical note and early results. Eur Spine J. 2007;16:1387–93.
Shim CS, Jung TG, Lee SH. Transcorporeal approach for disc herniation at the C2-C3 level. J Spinal Disord Tech. 2009;22(8):459–62.
Kim JS, Eun SS, Prada N, et al. Modified transcorporeal anterior cervical microforaminotomy assisted by O-arm based navigation. Eur Spine J. 2011;20(Suppl 2):S147–52.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Lee, J.H. (2020). Cervical Endoscopy Using Transcorporeal Route. In: Kim, JS., Lee, J., Ahn, Y. (eds) Endoscopic Procedures on the Spine. Springer, Singapore. https://doi.org/10.1007/978-981-10-3905-8_6
Download citation
DOI: https://doi.org/10.1007/978-981-10-3905-8_6
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-10-3904-1
Online ISBN: 978-981-10-3905-8
eBook Packages: MedicineMedicine (R0)