Turkish Neurosurgery 1998 , Vol 8 , Num 1-2
Süleyman İÇKE1, Serhat ERBAYRAKTAR2, Arif ÖSÜN3, Ünal KİRİŞOĞLU3, Metin GÜNER2
1Bornova Emergency Care and Traumatology Hospital Department of Neurosurgery, İzmir, Turkey
2Dokuz Eylül University Medical Faculty Department of Neurosurgery, İzmir, Turkey
3Yücelen Hospital Department of Neurosurgery, Muğla, Turkey
An evaluation of the advantages and limitations of both the anterior and posterior approaches was made in isolated cadaveric specimens of the cervical spine. During anterior decompressions, the Cloward drill with a diameter of 14 mm was used, and the vertebral borders of the interspace was dissected laterally with up-angled curettes. When decompressing via posteriorly, various sized medial facetectomies were performed. During each procedure, radiopaque markers were placed either for measuring the distances between the landmarks or x-ray evaluations. The mean length of the exposed nerve roots via anteriorly was 1.7 mm, and this could be increased to 3.8 mm when vigorous curettage was performed. The mean lengths of the the visible segments of the nerve roots in different cervical segments were in close relation with the extent of the facetectomies, and ranging between 5.0 and 7.2 mm. However, the risk of vertebral artery injury would seem to increase if the region of the uncovertebral joint was to be decompressed extensively via posteriorly. Because, not only the vertebral artery was closer to the most distal edge of the exposed nerve root segment than as it is in the anterior approach, but also the spinal cord and roots were hindering the exposure. We failed to demonstrate the actual extent of decompression on oblique x-ray views. Only the anteroposterior projections gave some information about the decompressive effect of facetectomy on the lateral wall of the neural foramen. Keywords : Anterior surgery, cervical radiculopathy, neural foramen, posterior surgery, x-ray evaluation
Corresponding author : Serhat Erbayraktar