期刊论文详细信息
Journal of Orthopaedic Surgery and Research
Tandem keyhole foraminotomy in the treatment of cervical radiculopathy: retrospective review of 35 cases
Hiroaki Nakamura1  Hirofumi Katsutani2  Kunikazu Kaneda2  Hiroyuki Yasuda1  Hiromitsu Toyoda1  Akinobu Suzuki1  Hidetomi Terai1 
[1] Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan;Department of Orthopaedic Surgery, Shimada Hospital, 100-1 Kashiyama, Habikino, Osaka 583-0875, Japan
关键词: Microsurgical decompression;    Cervical radiculopathy;    Keyhole foraminotomy;   
Others  :  813376
DOI  :  10.1186/1749-799X-9-38
 received in 2014-02-04, accepted in 2014-05-01,  发布年份 2014
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【 摘 要 】

Background

There has been no report regarding the results of two-level keyhole foraminotomy. The purpose of this study was to detail clinical outcomes following consecutive two-level cervical foraminotomy (tandem keyhole foraminotomy (TKF)) in patients with radiculopathy.

Methods

The authors conducted a retrospective review of 35 cases involving patients treated by a single surgeon using TKF. Clinical symptoms, data of physical examinations, pathology and clinical outcomes were detailed and discussed about this surgical method.

Results

Patients consisted of cervical disc herniation (CDH) (19/35), cervical spondylotic radiculopathy (CSR) (13/35), and cervical spondylotic amyotrophy (CSA) (3/35). TKF was performed from C3 to C5 in 2 patients (6%), from C4 to C6 in 7 patients (20%), from C5 to C7 in 23 patients (66%), and from C6 to T1 in 3 patients (8%). The mean operative duration was 99.2 min (range, 72 to 168 min). The mean estimated blood loss was 55.8 g (range, 0 to 200 g). Radicular pain was relieved within 3 months in 88% (29/32) and in 97% (31/32) at final follow-up. Resolution of muscle weakness was recognized within 6 months after operation in all CSA cases. Sixty-six percent of patients showed a greater than 20% deficit in grip weakness on the affected side compared with the normal side. After pain was relieved, grip strength improved by more than 15%.

Conclusions

TKF is a safe and highly effective procedure for patients with cervical radiculopathy and does not require invasive preoperative examinations. Further investigation is required to determine the effects of consecutive facetectomy.

【 授权许可】

   
2014 Terai et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Persson LC, Carlsson CA, Carlsson JY: Long-lasting cervical radicular pain managed with surgery, physiotherapy, or a cervical collar. A prospective, randomized study. Spine (Phila Pa 1976) 1997, 22(7):751-758.
  • [2]Lundine KM, Davis G, Rogers M, Staples M, Quan G: Prevalence of adjacent segment disc degeneration in patients undergoing anterior cervical discectomy and fusion based on pre-operative MRI findings. J Clin Neurosci 2014, 21(1):82-85.
  • [3]Fengbin Y, Xinwei W, Haisong Y, Yu C, Xiaowei L, Deyu C: Dysphagia after anterior cervical discectomy and fusion: a prospective study comparing two anterior surgical approaches. Eur Spine J 2013, 22(5):1147-1151.
  • [4]Henderson CM, Hennessy RG, Shuey HM Jr, Shackelford EG: Posterior-lateral foraminotomy as an exclusive operative technique for cervical radiculopathy: a review of 846 consecutively operated cases. Neurosurgery 1983, 13(5):504-512.
  • [5]Williams RW: Microcervical foraminotomy. A surgical alternative for intractable radicular pain. Spine (Phila Pa 1976) 1983, 8(7):708-716.
  • [6]Zeidman SM, Ducker TB: Posterior cervical laminoforaminotomy for radiculopathy: review of 172 cases. Neurosurgery 1993, 33(3):356-362.
  • [7]Jagannathan J, Sherman JH, Szabo T, Shaffrey CI, Jane JA: The posterior cervical foraminotomy in the treatment of cervical disc/osteophyte disease: a single-surgeon experience with a minimum of 5 years' clinical and radiographic follow-up. J Neurosurg Spine 2009, 10(4):347-356.
  • [8]Riew KD, Cheng I, Pimenta L, Taylor B: Posterior cervical spine surgery for radiculopathy. Neurosurgery 2007, 60(1 Supp1 1):S57-S63.
  • [9]De Luigi AJ, Fitzpatrick KF: Physical examination in radiculopathy. Phys Med Rehabil Clin N Am 2011, 22(1):7-40.
  • [10]Tanaka Y, Kokubun S, Sato T: Cervical radiculopathy and its unsolved problems. Current Orthopedics 1998, 12(1):1-6.
  • [11]Kang MS, Choi KC, Lee CD, Shin YH, Hur SM, Lee SH: Effective cervical decompression by posterior cervical foraminotomy without discectomy. J Spinal Disord Tech 2013. doi:10.1097/BSD.0b013e3182a35707
  • [12]Choi KC, Ahn Y, Kang BU, Ahn ST, Lee SH: Motor palsy after posterior cervical foraminotomy: anatomical consideration. World Neurosurg 2013, 79(2):405 e1-4.
  • [13]Rubinstein SM, Pool JJ, van Tulder MW, Riphagen II, de Vet HC: A systematic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy. Eur Spine J 2007, 16(3):307-319.
  • [14]Schoenfeld AJ, George AA, Bader JO, Caram PM Jr: Incidence and epidemiology of cervical radiculopathy in the United States military: 2000 to 2009. J Spinal Disord Tech 2012, 25(1):17-22.
  • [15]Choi G, Arbatti NJ, Modi HN, Prada N, Kim JS, Kim HJ, Myung SH, Lee SH: Transcorporeal tunnel approach for unilateral cervical radiculopathy: a 2-year follow-up review and results. Minim Invasive Neurosurg 2010, 53(3):127-131.
  • [16]Sekhon LH, Ball JR: Artificial cervical disc replacement: principles, types and techniques. Neurology India 2005, 53(4):445-450.
  • [17]Wigfield C, Gill S, Nelson R, Langdon I, Metcalf N, Robertson J: Influence of an artificial cervical joint compared with fusion on adjacent-level motion in the treatment of degenerative cervical disc disease. J Neurosurg 2002, 96(1 Suppl):17-21.
  • [18]Bhadra AK, Raman AS, Casey AT, Crawford RJ: Single-level cervical radiculopathy: clinical outcome and cost-effectiveness of four techniques of anterior cervical discectomy and fusion and disc arthroplasty. Eur Spine J 2009, 18(2):232-237.
  • [19]Northfield DW: Diagnosis and treatment of myelopathy due to cervical spondylosis. Br Med J 1955, 2(4954):1474-1477.
  • [20]Scoville WB, Whitcomb BB: Lateral rupture of cervical intervertebral disks. Postgrad Med 1966, 39(2):174-180.
  • [21]Suzuki A, Misawa H, Simogata M, Tsutsumimoto T, Takaoka K, Nakamura H: Recovery process following cervical laminoplasty in patients with cervical compression myelopathy: prospective cohort study. Spine (Phila Pa 1976) 2009, 34(26):2874-2879.
  • [22]Joghataei MT, Arab AM, Khaksar H: The effect of cervical traction combined with conventional therapy on grip strength on patients with cervical radiculopathy. Clin Rehabil 2004, 18(8):879-887.
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