Zeidman S M, Ducker T B
Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland.
Neurosurgery. 1993 Sep;33(3):356-62.
Laminoforaminotomy performed with the patient in the sitting position with our improved techniques represents an effective treatment for cervical radiculopathy. We present the results of laminoforaminotomies performed in 172 patients with cervical radiculopathy during a 7-year period. The posterior approach in the surgical management of cervical radiculopathy is not only acceptable, but in certain cases is preferable to the anterior approach. When the abnormality is central, broad based and anterior, posterior procedures are unlikely to achieve decompression. However, with lateral or foraminal nerve root compression, the simpler posterior keyhole laminoforaminotomy works well. In our opinion, physicians advocating either procedure exclusively are not providing the patient with the optimal level of care. Our purpose is to present in detail our surgical technique in conjunction with an analysis of our long-term results in clinical situations in which our technique is clearly indicated.
采用我们改良技术让患者取坐位进行椎板孔切开术是治疗神经根型颈椎病的一种有效方法。我们展示了在7年期间对172例神经根型颈椎病患者进行椎板孔切开术的结果。在神经根型颈椎病的外科治疗中,后路手术不仅是可行的,而且在某些情况下比前路手术更可取。当病变位于中央、基底较宽且靠前时,后路手术不太可能实现减压。然而,对于外侧或椎间孔神经根受压,更简单的后路锁孔椎板孔切开术效果良好。我们认为,只主张采用其中一种手术方法的医生没有为患者提供最佳的治疗水平。我们的目的是详细介绍我们的手术技术,并分析在明确适用我们技术的临床情况下的长期结果。