Advertisement

Minimally Invasive Posterior Cervical Decompression

  • Mena G. Kerolus
  • Joseph E. Molenda
  • Mazda K. Turel
  • Richard G. FesslerEmail author
Chapter

Abstract

Minimally invasive surgical (MIS) procedures for posterior cervical laminectomy, laminoforaminotomy and discectomy techniques were developed to reduce muscle dissection and soft tissue trauma. MIS posterior cervical laminoforaminotomy has been shown to reduce operative times, blood loss, postoperative pain and duration of hospital stays. In carefully selected patients with lateral foraminal disease, excellent surgical results can be expected. In this chapter, we will discuss the indications, contraindications, surgical technique and common surgical nuances involved in a posterior cervical decompression. A video illustration of an MIS posterior cervical laminoforaminotomy is also included.

Supplementary material

Video 18.1

Minimally invasive posterior cervical laminectomy (MPG 153430 kb)

References

  1. 1.
    Henderson CM, Hennessy RG, Shuey HM, Shackelford EG. Posterior-lateral foraminotomy as an exclusive operative technique for cervical radiculopathy: a review of 846 consecutively operated cases. Neurosurgery. 1983;13(5):504–12.CrossRefPubMedGoogle Scholar
  2. 2.
    Woertgen C, Holzschuh M, Rothoerl RD, Haeusler E, Brawanski A. Prognostic factors of posterior cervical disc surgery: a prospective, consecutive study of 54 patients. Neurosurgery. 1997;40(4):724–8.CrossRefPubMedGoogle Scholar
  3. 3.
    Lidar Z, Salame K. Minimally invasive posterior cervical discectomy for cervical radiculopathy: technique and clinical results. J Spinal Disord Tech. 2011;24(8):521–4.PubMedGoogle Scholar
  4. 4.
    Lawton CD, Smith ZA, Lam SK, Habib A, Wong RHM, Fessler RG. Clinical outcomes of microendoscopic foraminotomy and decompression in the cervical spine. World Neurosurg. 2014;81(2):422–7.CrossRefPubMedGoogle Scholar
  5. 5.
    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.CrossRefPubMedGoogle Scholar
  6. 6.
    Holly LT, Moftakhar P, Khoo LT, Wang JC, Shamie N. Minimally invasive 2-level posterior cervical foraminotomy: preliminary clinical results. J Spinal Disord Tech. 2007;20(1):20–4.CrossRefPubMedGoogle Scholar
  7. 7.
    Kim K-T, Kim Y-B. Comparison between open procedure and tubular retractor assisted procedure for cervical radiculopathy: results of a randomized controlled study. J Korean Med Sci. 2009;24(4):649–53.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Fessler RG, Khoo LT. Minimally invasive cervical microendoscopic foraminotomy: an initial clinical experience. Neurosurgery. 2002;51(5 Suppl):S37–45.PubMedGoogle Scholar
  9. 9.
    Clark JG, Abdullah KG, Steinmetz MP, Benzel EC, Mroz TE. Minimally invasive versus open cervical foraminotomy: a systematic review. Global Spine J. 2011;1(1):9–14.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    McAnany SJ, Kim JS, Overley SC, Baird EO, Anderson PA, Qureshi SA. A meta-analysis of cervical foraminotomy: open versus minimally-invasive techniques. Spine J. 2015;15(5):849–56.CrossRefPubMedGoogle Scholar
  11. 11.
    Winder MJ, Thomas KC. Minimally invasive versus open approach for cervical laminoforaminotomy. Can J Neurol Sci. 2011;38(2):262–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Wirth FP, Dowd GC, Sanders HF, Wirth C. Cervical discectomy. A prospective analysis of three operative techniques. Surg Neurol. 2000;53(4):340–6.CrossRefPubMedGoogle Scholar
  13. 13.
    Mansfield HE, Canar WJ, Gerard CS, O’Toole JE. Single-level anterior cervical discectomy and fusion versus minimally invasive posterior cervical foraminotomy for patients with cervical radiculopathy: a cost analysis. Neurosurg Focus. 2014;37(5):E9.CrossRefPubMedGoogle Scholar
  14. 14.
    Liu W-J, Hu L, Chou P-H, Wang J-W, Kan W-S. Comparison of anterior cervical discectomy and fusion versus posterior cervical foraminotomy in the treatment of cervical radiculopathy: a systematic review. Orthop Surg. 2016;8(4):425–31.CrossRefPubMedGoogle Scholar
  15. 15.
    Ruetten S, Komp M, Merk H, Godolias G. Full-endoscopic cervical posterior foraminotomy for the operation of lateral disc herniations using 5.9-mm endoscopes: a prospective, randomized, controlled study. Spine. 2008;33(9):940–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Soliman HM. Cervical microendoscopic discectomy and fusion: does it affect the postoperative course and the complication rate? A blinded randomized controlled trial. Spine. 2013;38(24):2064–70.CrossRefPubMedGoogle Scholar
  17. 17.
    Gutman G, Rosenzweig DH, Golan JD. The surgical treatment of cervical radiculopathy: meta-analysis of randomized controlled trials. Spine. 2017. doi:  10.1097/BRS.0000000000002324. [Epub ahead of print].
  18. 18.
    Shamji MF, Cook C, Pietrobon R, Tackett S, Brown C, Isaacs RE. Impact of surgical approach on complications and resource utilization of cervical spine fusion: a nationwide perspective to the surgical treatment of diffuse cervical spondylosis. Spine J. 2009;9(1):31–8.CrossRefPubMedGoogle Scholar
  19. 19.
    Dahdaleh NS, Wong AP, Smith ZA, Wong RH, Lam SK, Fessler RG. Microendoscopic decompression for cervical spondylotic myelopathy. Neurosurg Focus. 2013;35(1):E8.CrossRefPubMedGoogle Scholar
  20. 20.
    Abbas SF, Spurgas MP, Szewczyk BS, Yim B, Ata A, German JW. A comparison of minimally invasive posterior cervical decompression and open anterior cervical decompression and instrumented fusion in the surgical management of degenerative cervical myelopathy. Neurosurg Focus. 2016;40(6):E7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Mena G. Kerolus
    • 1
  • Joseph E. Molenda
    • 1
  • Mazda K. Turel
    • 1
  • Richard G. Fessler
    • 1
    Email author
  1. 1.Department of NeurosurgeryRush University Medical CenterChicagoUSA

Personalised recommendations