gms | German Medical Science

63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

13. - 16. Juni 2012, Leipzig

Endoscopic foraminoplasty for cervical radiculopathy

Meeting Abstract

Suche in Medline nach

  • Y. Nishimura - Spinal Surgery Centre, Department of Neurosurgery, KOYO Hospital, Wakayama, Japan
  • K. Kubo - Spinal Surgery Centre, Department of Neurosurgery, KOYO Hospital, Wakayama, Japan
  • N. Nakao - Department of Neurosurgery, Wakayama Medical University, Wakayama, Japan
  • T. Luebbers - Wirbelsäulenzentrum, Ludmillenstift, Meppen, Germany

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocDO.13.07

DOI: 10.3205/12dgnc120, URN: urn:nbn:de:0183-12dgnc1208

Veröffentlicht: 4. Juni 2012

© 2012 Nishimura et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Regarding cervical radiculopathy, anterior inter-body fusion and anterior or posterior foraminotomy are widely performed, and good outcomes have been obtained. Our institute obtained good results by performing foraminoplasty using a spinal endoscope on radiculopathy from foraminal stenosis due to lateral disc herniation and bone spurs. We will investigate the practicality and outcome of the operation as well as its adaptations, and will hereby report on them in addition to several discussions.

Methods: Our institute introduced endoscopes to posterior cervical spine surgeries from 2007, and have since performed 143 cases of endoscopic surgery on the posterior cervical spine as of October 2011. Of these, the subjects were 25 cases of 28 intervertebral lesions in which foraminoplasty was performed for radiculopathy. Surgery was performed under general anaesthesia, and an endoscope with a tubular retractor and rigid scope, a so-called MED, was used. Regarding the standard of intervertebral foramen decompression, the inner 50% of the facet joint of concern was determined to be the limit. Post-operational external fixation was not required.

Results: Dramatic improvement was observed in the treatment criterion for cervical radiculopathy from an early postoperative period in roughly all cases, from a preoperative average of 6.4 points to an average of 17.2 points at the final postoperative investigation. Intraarticular decompression was approximately 52.1% upon measurement by postoperative CT. Regarding complications, RSD-like pain occurred on the palm of the hand in one case, but disappeared after 2 months of conservative therapy. There were no cases of instability. Disappearance was observed in all hernia cases, with complete disappearance in one case. There were no cases of an analgesic being used to treat pain.

Conclusions: If posterior cervical endoscopic foraminotomy (foraminoplasty) is performed by a skilled surgeon, then the amount of bleeding and postoperative pain is low, fixation is not required, and it is believed that it may be selected as an operative procedure that is minimally invasive and useful.