Сervical microdiscectomy: method and surgical strategy
DOI:
https://doi.org/10.25305/unj.86579Keywords:
herniated disc, surgical treatment, cervical microdiscectomy, interlaminar approachAbstract
Objective. To implement the interlaminar lateral approach for extraction of herniated discs (HD) in the cervical spine.
Materials and methods. During 2012–2015 in Regional psychoneurological hospital 56 patients with cervical HD were operated. There were 22 females, 36 males among them. Disc herniation at the CV–CVI level occurred in 21 cases, CVI–CVII in 20 cases. The main disease signs were cervicalgia, monoradiculopathy. Fifty patients with medial hernia were operated using anterior cervical microscopic discectomy approach to HP extraction and intervertebral cage implantation (PEEK material). Six patients with lateral hernia were operated using posterior interlaminar cervical microdiscectomy. Anterior approach was performed by a standard method using CODMAN retractor, high-speed drill Stryker TPS. The posterior interlaminar approach was performed using paramedian incision 3 cm, intermuscular approach to the posterior lateral mass and arch on the affected side with Medtronic Metrix system followed by interlaminectomy performed by high-speed drill not more than 1 cm that was rather enough for hernia extraction from under nerve root.
Results. In all cases we managed to achieve the regression of radicular and cervicalgia syndromes. No complications were fixed during both surgical approaches. There was no difference observed in duration of surgical intervention using both methods, which was about (64±12) min. All patients were verticalized and activated in 3–4 hours after surgery.
Conclusion. Cervical microdiscectomy is a standard method for cervical HD surgery. The posterior interlaminar approach is an effective method used for lateral herniations, especially sequestered ones. It promotes the preservation of intervertebral disc and reduction of the total cost of surgery due to no necessity to use the implants-prosthesis. We suppose the posterior cervical microdiscectomy of lateral, sequestered intervertebral disc herniations in cervical spine to become a standard method of treatment.
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Copyright (c) 2016 Valeriy Olkhov, Kostyantyn Horbatyuk, Oleksiy Stoliarenko
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