Article
Endoscopic foraminoplasty for cervical radiculopathy
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Authors
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Y. Nishimura
- Spinal Surgery Centre, Department of Neurosurgery, KOYO Hospital, Wakayama, Japan
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K. Kubo
- Spinal Surgery Centre, Department of Neurosurgery, KOYO Hospital, Wakayama, Japan
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N. Nakao
- Department of Neurosurgery, Wakayama Medical University, Wakayama, Japan
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T. Luebbers
- Wirbelsäulenzentrum, Ludmillenstift, Meppen, Germany
| Published: | June 4, 2012 |
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Outline
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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.
