Salvatore Chibbaro, Orphee Makiese, Damien Bresson, Alisha Reiss, Pavel Poczos, Bernard George
Department of Neurosurgery, Lariboisiere University Hospital, 75475 Paris Cedex 10, France.
Neurol Res Int. 2011;2011:734232. doi: 10.1155/2011/734232. Epub 2011 Oct 19.
Background. The authors describe a lateral approach to the cervical spine for the management of spondylotic myeloradiculopathy. The rationale for this approach and surgical technique are discussed, as well as the advantages, disadvantages, complications, and pitfalls based on the author's experience over the last two decades. Methods. Spondylotic myelo-radiculopathy may be treated via a lateral approach to the cervical spine when there is predominant anterior compression associated with either spine straightening or kyphosis, but without vertebral instability. Results. By using a lateral approach, the lateral aspect of the cervical spine and the vertebral artery are easily reached and visualized. Furthermore, the lateral part of the affected intervertebral disc(s), uncovertebral joint(s), vertebral body(ies), and posterior longitudinal ligament can be removed as needed to decompress nerve root(s) and/or the spinal cord. Conclusion. Multilevel cervical oblique corpectomy and/or lateral foraminotomy allow wide decompression of nervous structures, while maintaining optimal stability and physiological motion of the cervical spine.
背景。作者描述了一种用于治疗脊髓型颈椎病的颈椎外侧入路。讨论了该入路的原理和手术技术，以及基于作者过去二十年经验的优点、缺点、并发症和陷阱。方法。当存在与脊柱变直或后凸相关的主要前方压迫但无椎体不稳定时，脊髓型颈椎病可通过颈椎外侧入路进行治疗。结果。通过采用外侧入路，颈椎外侧和椎动脉很容易到达并可视化。此外，可根据需要切除受影响椎间盘、钩椎关节、椎体和后纵韧带的外侧部分，以减压神经根和/或脊髓。结论。多级颈椎斜行椎体次全切除术和/或外侧椎间孔切开术可实现神经结构的广泛减压，同时保持颈椎的最佳稳定性和生理活动度。
