Grundy P L, Germon T J, Gill S S
Department of Neurosurgery, Frenchay Hospital, Bristol, United Kingdom.
J Neurosurg. 2000 Jul;93(1 Suppl):21-7. doi: 10.3171/spi.2000.93.1.0021.
The anterolateral and posterior transpedicular foraminotomies were 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. The use of the pedicle to obtain access to compressive uncovertebral osteophytes, without causing damage to the motion segment, has not been previously reported.
The authors present the early outcome data obtained in 27 patients who underwent an anterolateral or posterior foraminotomy. Eighty-eight percent of patients who underwent anterolateral foraminotomy and 94% of those who underwent a posterior transpedicular procedure experienced complete or significant relief of brachialgia. Postoperatively none of the patients were symptomatically or neurologically worse.
The transpedicular approach is an effective and potentially improved method of treating symptomatic cervical uncovertebral osteophytes compared with techniques previously described.
开发前外侧和后经椎弓根椎间孔切开术以加强对继发于钩椎骨赘的神经根型颈椎病的治疗。这些新颖的手术方法可能具有优势,因为它们在保留运动节段正常活动和稳定性的同时,可直接对神经根进行减压。利用椎弓根进入压迫性钩椎骨赘而不损伤运动节段,此前尚未见报道。
作者展示了27例行前外侧或后椎间孔切开术患者的早期结果数据。行前外侧椎间孔切开术的患者中88%以及行后经椎弓根手术的患者中94%的臂痛得到完全或显著缓解。术后所有患者症状和神经功能均未恶化。
与先前描述的技术相比,经椎弓根入路是治疗有症状的颈椎钩椎骨赘的一种有效且可能更佳的方法。