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Selective Cervical Laminectomy of Limited Width by Muscle-Sparing Technique Using Anatomical Plane Exposures

  • Tateru Shiraishi
  • Ryoma Aoyama
Chapter

Abstract

In conventional surgical exposure for posterior cervical spine surgeries, the deep extensor muscles and intervertebral joints with their capsules are damaged, sometimes resulting in unstable spine, abnormal spinal curvature, and residual neck and shoulder pain. To prevent such problems, laminectomy has been frequently combined with instrumentation. Recent laminoplasties has been reinforced with metal devices to hold the expanded laminae. Under such circumstances, the medical cost for spine care might be skyrocketing.

Muscle-sparing selective cervical laminectomy is performed through intermuscular planes aided with a microscope.

The width of laminectomy is limited to be 2–3 mm wider than the spinal cord measured on preoperative T2-weighted axial MRI for each patient.

This narrow laminectomy with limited exposure makes complete preservation of the intervertebral joints with their capsules to successfully maintain cervical stability and mobility without instrumentation and substantially reduces medical costs.

Postoperative care is simplified by less wound pain and early mobilization without even a soft brace, realizing early return to job.

Supplementary material

Video 66.1

Caption(MP4 336,424 kb)

Video 66.1

Caption (MP4 68,669 kb)

References

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Tateru Shiraishi
    • 1
  • Ryoma Aoyama
    • 1
  1. 1.Department of OrthopaedicsTokyo Dental College Ichikawa General HospitalChibaJapan

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