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Korean J Spine Search

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Extended Anterior Cervical Microforaminotomy for Migrated Cervical Disc
Keun-Sik Kim, M.D., Sung-Sam Jung, M.D., Ho-Gyun Ha, M.D., Seung-Yung Jung, M.D., Seung-Min Kim, M.D., Jae-Hwan Cha, M.D.
Department of Neurosurgery, College of Medicine, Eul-Ji University, Daejeon, Korea
광범한 전방 경추 미세 추간공 확대술을 이용한 이동형 경추 추간판 탈출증의 치료
김근식,정성삼,하호균,정승영,김승민,차재환
을지대학교 의과대학 신경외과학교실
Abstract
Objective: The anterior cervical microforaminotomy technique has been developed to enhance the treatment of cervical spondylotic radiculopathy secondary to uncovertebral osteophytes. These novel surgical approaches may be advantageous because they allow direct decompression of the nerve root while preserving normal movement and stability of the motion segment. But, the use of this technique is limited for the treatment of large migrated cervical disc herniation that is generally treated by conventional approach through an anterior diskectomy followed by bone-graft reconstruction. The authors has applied 'extended anterior cervical microforaminotomy' for these lesions on minimally invasive basis.
Methods: For these lesions, the anterior foraminotomy is made like a flask-shaped hole, with a smaller outer opening similar to that for the anterior cervical microforaminotomy but incorporating a larger inner opening to accommodate the extent of the large migrated disc in a longitudinal and transverse dimension; however, it does not require bone fusion or postoperative immobilization. The surgical technique is described with two illustrated patients. The authors present the early outcome data obtained in 9 patients who underwent the extended anterior cervical microforaminotomy.
Results: The outcome was excellent in 7 patients (78%) and good in 2 patients(22%) based on Odom's criteria. None of the patients were symptomatically or neurologically worse. Spinal stability was well maintained postoperatively.
Conclusion: This extended anterior cervical microforaminotomy technique has shown excellent clinical outcomes with fast recovery and adequate anatomical decompression in patients with migrated cervical disc herniation.
Keywords: Extended anterior cervical microforaminotomy.Migrated cervical disc herniation.Minimally invasive surgery


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