A Comparative Study on the Minimal Invasiveness of Full-Endoscopic and Microendoscopic Cervical Foraminotomy Using Intraoperative Motor Evoked Potential Monitoring

Medicina

Hiroki Iwai¹  Hisashi Koga¹  Hirohiko Inanami²  Ryutaro Shiboi³  Hirotaka Kawano⁴  Muneyoshi Fujita⁴  Masahiro Hirahata⁴  Tomoaki Kitagawa⁴ 

[1] Department of Neurosurgery, Iwai FESS Clinic, 8-18-4 Minamikoiwa, Edogawa-ku, Tokyo 133-0056, Japan;Department of Orthopaedic Surgery, Iwai Orthopaedic Medical Hospital, 8-17-2 Minamikoiwa, Edogawa-ku, Tokyo 133-0056, Japan;Department of Orthopaedic Surgery, Oono Central Hospital, 3-20-3 Shimokaizuka, Ichikawa-shi, Chiba 272-0821, Japan;Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan;

关键词: intraoperative motor evoked potential monitoring;    full-endoscopic cervical foraminotomy;    microendoscopic cervical foraminotomy;    cervical radiculopathy;   

DOI  :  10.3390/medicina56110605

来源: DOAJ

【 摘 要 】

Background and Objectives: Full-endoscopic cervical foraminotomy (FECF) and microendoscopic cervical foraminotomy (MECF) are effective surgeries for cervical radiculopathy and are considered minimally invasive in terms of damage to paraspinal soft tissue. However, no studies have quantitatively compared FECF and MECF in terms of neurological invasiveness. The aim of this study was to compare the neurological invasiveness of FECF and MECF using intraoperative motor evoked potential (MEP) monitoring. Materials and Methods: A chart review was conducted of 224 patients with cervical radiculopathy who underwent FECF or MECF between April 2014 and March 2020. Patients were 37 women and 187 men, with a mean age of 51 (range, 21–86) years. FECF was performed in 143 cases and MECF was performed in 81 cases. Results: Average MEP amplitude significantly increased from 292 mV before to 677 mV after nerve root decompression in patients who underwent the FECF. The average improvement rate was 273%. In patients who underwent the MECF, average MEP amplitude significantly increased from 306 mV before to 432 mV after nerve root decompression. The average improvement rate was 130%. The improvement rate was significantly higher for FECF compared with MECF. Conclusions: MEP amplitude increased after nerve root decompression in both FECF and MECF, but the improvement rate was higher in FECF. These results suggest that FECF might be more minimally invasive than MECF in terms of neurological aspects.

【 授权许可】

Unknown