SURGIAL RESULT OF PATIENTS UNDERGOING POSTERIOR CERVICAL LAMINOFORAMINOTOMY : RETROSPEKTIVE STUDY

Yıl 2020, , 230 - 235, 01.07.2020

Serhat Yildizhan , Mehmet Gazi Boyacı , Adem Aslan

https://doi.org/10.18229/kocatepetip.642263

Öz

OBJECTIVE: Many factors determine the approach towards cervical disc hernias from the anterior or posterior. Nowadays, the posterior approach is less preferable compared to the anterior intervention. In this study, we evaluated the post-operative results of patients with cervical disc hernias and cervical foraminal stenosis who were suitable for posterior intervention and were operated on by this method.
MATERIAL AND METHODS: The clinical and post-operative results of 28 patients, who underwent surgery with the posterior cervical approach between June 2014 and June 2018, were discussed.
RESULTS: The 28 patients who underwent surgery with the posterior approach, 16 were male, 12 were female, and the mean age was 47.8 years (age range 40-66 years). All patients had a complaint of unilateral radiculopathy, with 18 of them on the left side and 10 of them on the right side. Sixteen of the patients had a soft ruptured cervical disc, and 12 were diagnosed with foraminal stenosis.
CONCLUSIONS: Posterior level laminoforaminotomy is one of the most suitable options in cervical disc hernias and cervical foraminal stenosis in the selected patients. This method provides better clinical results in soft ruptured disc patients.

Anahtar Kelimeler

Cervical disc hernia, Foraminal stenosis, Posterior laminoforaminotomy

POSTERİOR SERVİKAL LAMİNOFORAMİNOTOMİ YAPILAN HASTALARIN CERRAHİ SONUÇLARI : RETROSPEKTİF ÇALIŞMA

Öz

AMAÇ: Servikal disk hernilerine anterior veya posteriordan yaklaşımı belirleyen birçok faktör vardır. Günümüzde posterior yaklaşım anterior girişime oranla daha az tercih edilmektedir. Bu çalışmamızda servikal disk hernisi ve servikal foraminal stenozu bulunan ve posterior girişime uygun olup bu yöntemle opere edilen hastaların post-operatif sonuçlarını değerlendirdik.
GEREÇ VE YÖNTEM: Haziran 2014 ve Haziran 2018 seneleri arasında posterior servikal yaklaşımla ameliyat edilmiş 28 hastanın, klinik ve post-operatif sonuçları tartışıldı.
BULGULAR: Posterior yaklaşımla ameliyat edilmiş 28 hastanın 16 tanesi erkek, 12 tanesi kadındı ve ortalama yaş 47.8 (yaş aralığı 40-66 yıl) idi. Hastaların hepsinde tek taraflı radikülopati şikayeti mevcuttu. 18 tanesi sol, 10 tanesi sağ taraf kaynaklıydı. Hastaların 16 tanesi yumuşak rüptüre servikal disk, 12 tanesi foraminal stenoz tanılı idi.
SONUÇ: Posterior servikal laminoforaminotomi seçilmiş hastalarda servikal disk hernisinde ve servikal foraminal stenozda en uygun seçeneklerden birisidir. Bu yöntem yumuşak rüptüre disk hastalarında daha iyi klinik sonuç vermektedir.

Anahtar Kelimeler

Servikal disk hernisi, Foraminal stenoz, posterior laminoforaminotomi

Kaynakça

• Caglar YS, Bozkurt M, Kahilogullari G, Tuna H, Bakir A, Torun F, et al. Keyhole approach for posterior cervical discectomy: experience on 84 patients. Minim Invasive Neurosurg. 2007;50:7–11.
• Henderson CM, Hennessy RG, Shuey HM, Jr, Shackelford EG. Posterior-lateral foraminotomy as an exclusive operative technique for cervical radiculopathy: a review of 846 consecutively operated cases. Neurosurgery. 1983;13:504–512.
• Zeidman SM, Ducker TB. Posterior cervical laminoforaminotomy for radiculopathy: review of 172 cases. Neurosurgery. 1993;33:356–362.
• Raynor RB, Pugh J, Shapiro I. Cervical facetectomy and its effect on spine strength. J Neurosurg. 1985;63:278–282.
• Zdeblick TA, Zou D, Warden KE, McCabe R, Kunz D, Vanderby R. Cervical stability after foraminotomy. A biomechanical in vitro analysis. J Bone Joint Surg Am. 1992;74:22–27.
• Chang JC, Park HK, Choi SK. Posterior cervical inclinatory foraminotomy for spondylotic radiculopathy preliminary. J Korean Neurosurg Soc 2011; 49: 308-13.
• Clarke MJ, Ecker RD, Krauss WE, McClelland RL, Dekutoski MB. Samesegment and adjacent segment disease following posterior cervical foraminotomy. J Neurosurg Spine 2007; 6: 5-9.
• Kim CH, Chung CK, Kim HJ, Jahng TA, Kim DG. Early outcome of posterior cervical endoscopic discetomy: an alternative teratment choice for physically/socially active patients. J Korean Med Sci 2009; 24: 302-6.
• Hunt WE, Miller CA. Management of cervical radiculopathy. Clin Neurosurg. 1986;33:485–502.
• Samii M, Völkening D, Sepehrnia A, Penkert G, Baumann H. Surgical treatment of myeloradiculopathy in cervical spondylosis. A report on 438 operations. Neurosurg Rev. 1989;12:285–290.
• Herkowitz HN, Kurz LT, Overholt DP. Surgical management of cervical soft disc herniation. A comparison between the anterior and posterior approach. Spine (Phila Pa 1976) 1990;15:1026–1030.
• Harrop J, Silva MT, Sharan AD, Dante SJ, Simeone FA. Cervicothoracic radiculopathy treated using posterior cervical foraminotomy/discectomy. J Neurosurg (Spine 2) 2003; 98: 131-6.
• Epstein NE. A review of laminoforaminotomy for the management of lateral and foraminal cervical disc herniations or spurs. Surg Neurol 2002; 57: 226-34.
• Fressler RG, Khoo LT. Minimally invasive cervical microendoscopic foraminotomy: An initial clinical experience. Neurosurgery 2002; 51: 537-45.
• Kunert P, Prokopienko M, Marchel A. Posterior microlaminoforaminotomy for cervical disc herniation. Neurol Nurochir Pol 2010; 44: 375-84.
• Witzmann A, Hejazi N, Krasznai L. Posterior cervical foraminotomy. A follow-up study of 67 surgically treated patients with compressive radiculopathy. Neurosurg Rev 2000; 23: 213-17
• Krupp W, Schattke H, Müke R. Clinical results of the foraminotomy as described by Frykholm for the treatment of lateral cervical disc herniation. Acta Neurochir (Wien) 1990;107:22–29.
• Woertgen C, Holzschuh M, Rothoerl RD, Haeusler E, Brawanski A. Prognostic factors of posterior cervical disc surgery: a prospective, consecutive study of 54 patients. Neurosurgery. 1997;40:724–728.
• Yoo HJ, Parkı JH, Seong HY, Roh SW. Comparison of Surgical Results between Soft Ruptured Disc and Foraminal Stenosis Patients in Posterior Cervical Laminoforaminotomy. Korean Journal of Neurotrauma. 2017; 13(2): 124–129.
• Baba H, Chen Q, Uchida K, Imura S, Morikawa S, Tomita K. Laminoplasty with foraminotomy for coexisting cervical myelopathy and unilateral radiculopathy: a preliminary report. Spine. 1996;21:196–202.
• Chen BH, Natarajan RN, An HS, Andersson GB. Comparison of biomechanical response to surgical procedures used for cervical radiculopathy: posterior keyhole foraminotomy versus anterior foraminotomy and discectomy versus anterior discectomy with fusion. J Spinal Disord. 2001;14:17–20.