When the cervical disorder is serious and is caused by more than a simple disc space problem, then doctor can recommend surgery where he will remove not just vertebral body but also the disc spaces at either end so that the cervical canal can be decompressed completely. Figure 3 from oblique corpectomy to manage cervical. Technically, a corpectomy is a more difficult spine surgery to perform. Adverse events associated with anterior cervical spine surgery. Cervical spondylotic myelopathy csm is a syndrome describing a wide spectrum of degenerative changes within the cervical motion segments that ultimately result in spinal cord compression at one or more levels. Pdf the value of intraoperative ultrasound in oblique. Clinical and radiological outcomes in 153 patients undergoing oblique corpectomy for cervical spondylotic myelopathy. Endoscopic partial cervical corpectomy opening a new door to create a wider window mazda k turel 1, ari g chacko 2 1 department of neurosurgery, wockhardt hospitals, mumbai, maharashtra, india 2 division of neurosurgery, christian medical college and hospitals, vellore, tamil nadu, india.
Multilevel cervical oblique corpectomy in the treatment of. The evidence of failure of long constructs has been investigated in biomechanical studies. The authors describe a lateral approach to the cervical spine for the management of spondylotic myeloradiculopathy. To assess the longterm clinical and radiographic outcomes of anterior cervical corpectomy and fusion accf with a neotype nanohydroxyapatitepolyamide 66 nhapa66 strut in the treatment of. Anterior cervical corpectomy risks and complications. The rationale for this approach and surgical technique are discussed, as well as the advantages, disadvantages, complications, and pitfalls based on the authors experience over the last two decades. Over last few years various clinical series 3439 about oblique corpectomy as well as experimental studies 40, 41 have been published. Multilevel oblique corpectomy for cervical spondylotic myelopathy. C5 cervical spine corpectomy with adjustable interbody cage placement. In a series of 5 patients undergoing multilevel oblique corpectomy for cervical myelopathy, 3 had opll with massive oall that was asymptomatic. Imageguided navigation in anterior cervical spine surgery using a. The oblique corpectomy according to goel was first described in 2005. Acdf with corpectomy orthopedic coding ask an expert.
Although posteriorly based osteotomies of the cervical spine have been described in the past, there are no reports of the surgical technique for performing an anterior. Endoscopic or oblique partial corpectomy improves the sagittal canal. Cervical spondylotic myelopathy and radiculopathy treated. Since 1992, we have developed an alternative technique to the anterior approach and median corpectomy, which is the oblique corpectomy through a lateral approach to the cervical spine. Accf actually means a total incision of the pathology that requires fusion graft or cage for spinal stabilization. Multilevel oblique corpectomies are an available and safe option for the treatment of upper cervical chordomas. Multilevel oblique corpectomy moc is an emerging technique for surgical treatment of multisegmental cervical spondylotic myelopathy csm featuring extensive ossification of the posterior longitudinal ligament opll.
Anterior cervical corpectomy anterior in the human anatomy, referring to the front surface of the body or position of one structure relative to another cervical relating to the neck, in the spine relating to the. Multilevel oblique corpectomy for cervical spondylotic. Longterm results of anterior cervical corpectomy and fusion. Caring for myself after anterior cervical corpectomy fusion. Do not keep the wound covered unless you have some drainage, and we instructed to do so. Anterior cervical corpectomy orthopaedicsone articles. Although posteriorly based osteotomies of the cervical spine have been described in the past, there are no reports of the surgical technique for performing an. Cervical corpectomy is a ventral cervical spine procedure. Lumbar corpectomy at the southeastern spine institute.
An anterior cervical corpectomy is a surgical procedure in which vertebral bone and intervertebral disc material is removed to relieve pressure on the spinal cord and spinal nerves decompression in the cervical spine, or neck. Anterior cervical corpectomy and the operating team. Cervical spondylotic myelopathy treated by oblique corpectomy. Jul 01, 2012 read multilevel oblique corpectomy for cervical spondylotic myelopathy preserves segmental motion, european spine journal on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Multilevel oblique corpectomy for cervical spondylotic myelopathy preserves segmental motion. The reason it is attractive that it allows for a long segment of decompression up to five levels without the need for a bone graft or instrumentation as its proponents. Oblique corpectomy in the cervical spine spinal cord. The technique of oblique corpectomy has been reported for the first time in 1993 to access lesions developed in the anterior part of the spinal canal. Surgery for multilevel cervical spondylotic myelopathy and ossified.
It is important that all patients are physically and psychologically prepared. Oblique corpectomy in the cervical spine request pdf. The opll was removed using microdrills while preserving the oall. Longterm results of anterior cervical corpectomy and. Oblique corpectomy to manage cervical myeloradiculopathy ncbi. Anterior cervical corpectomy at the southeastern spine. In an oblique cervical corpectomy, the vertebral body is drilled from an anterolateral trajectory causing ventral decompression. It involves the removal of the vertebral body as well as the disc spaces at either end, to completely decompress the cervical canal.
To perform an evidence synthesis of the literature assessing the efficacy of arthroplasty, oblique corpectomy without fusion, and skip laminectomy to treat symptomatic cervical spondylotic myelopathy csm. Anterior cervical corpectomy is an approved and effective method for fusing the cervical spine to treat cervical spinal stenosis. Comparison of multilevel oblique corpectomy with and without. Reimbursement nuvasive is dedicated to offering resources for healthcare professionals seeking a better understanding of coding, coverage, and payment related to our technologies and therapies. Figure 6 from oblique corpectomy to manage cervical. The anterolateral cervical approach with oblique corpectomy was used to remove it. It can be taken either as an anterior oblique or posterior oblique projection. Even the latest cci says code 22551 is a column 2 code for 63081, but a modifier is allowed in order to differentiate between the services provided.
However, when the disc is already dehydrated and collapsed, as is commonly observed in spondylosis of the cervical spine, no grafting or osteosynthesis is necessary. The procedure of oblique cervical corpectomy occ illustrates maintenance of a considerable part of the ventral and lateral sides of the vertebral body. Pdf on jan 24, 2018, salvatore chibbaro and others published multilevel oblique corpectomy find, read and cite all the research you need on researchgate. Similar to a discectomy, the risks and possible complications of this surgery for cervical spinal stenosis include. Multisegmental cervical spondylotic myelopathy and. This retrospective study included 109 patients93 with cervical spondylotic myelopathy and 16 with ossified posterior longitudinal ligament in whom spinal curvature and range of segmental movements were assessed on neutral and. The prevertebral muscles were resected so as to expose the transverse.
Multilevel oblique corpectomy without fusion in managing. An anterior cervical corpectomy is a procedure performed when cervical disease encompasses more than just the disc space, such as multilevel cervical stenosis or spinal cord compression caused by bone spur growth. All patients presented with symptoms of progressively increasing myelopathy. Limited oblique corpectomy for treatment of ossified. Read article for free, from open access legal sources, via unpaywall. Postoperative a coronal and c axial ct scan showing wide spinal canal decompression after 1 level moc. Do not go in bath tubs, lakes, pools, or hot tubs until wound is completely healed. C5 cervical corpectomy with interbody cage youtube. These procedures are highly successful in treating. To document the neurological outcome, spinal alignment and segmental range of movement after oblique cervical corpectomy occ. To determine whether motion preservation following oblique cervical corpectomy occ for cervical spondylotic myelopathy csm persists with serial followup. Adverse events associated with anterior cervical spine surgery abstract anterior cervical procedures for neurologic decompression and fusion, including cervical diskectomy and cervical corpectomy, are commonly performed by orthopaedic surgeons and spinal neurosurgeons.
C5 cervical corpectomy with interbody cage uscneurosurgery. Multilevel oblique corpectomies as an effective surgical. Eighteen months after surgery the patient is still free from illness. The choice of the technique of oblique corpectomy without fusion was made with consideration of the anatomic factors, including the anterior location of the compressive elements, the loss of the normal lordosis of the cervical spine axis, which had become straight or even kyphotic, and the stability of the cervical spine. Alternative procedures for the treatment of cervical. However, the use of an oblique drilling plane is unfamiliar to most surgeons and there is no anatomical landmark. In between each of the 7 vertebrae of the cervical spine are soft pads or discs which act as shockabsorbers and allow for bending and movement of the head. The oblique corpectomy preserves the ventral half of the vertebral body and does not require stabilization. The purpose of this article is to detail the advantages and disadvantages of this technique and to describe the preoperative selection criteria and the. Comparison of multilevel oblique corpectomy with and. Multilevel cervical oblique corpectomy andor lateral foraminotomy allow wide decompression of nervous structures, while maintaining optimal. Four patients with cervical seas were treated with oblique corpectomy in our department over the last 10 years.
Reduction in range of cervical motion on serial longterm. Comparison of multilevel oblique corpectomy with and without image guided navigation for multisegmental cervical spondylotic myelopathy. Corpectomy with adjacentlevel kyphoplasty to treat. This retrospective study included 109 patients93 with cervical spondylotic myelopathy and 16 with ossified posterior longitudinal ligament in whom spinal curvature and range of segmental. The cervical spine runs from the brain down through the cervical spine, controlling the bodys organs and limbs. Multilevel cervical oblique corpectomy andor lateral foraminotomy. Jul 01, 20 read reduction in range of cervical motion on serial longterm followup in patients undergoing oblique corpectomy for cervical spondylotic myelopathy, european spine journal on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips.
How to read a mri of cervical stenosis with spinal cord injury. Subaxial cervical spine injury classification slic injury morphology points compression burst 1 1. Cervical corpectomy and fusion anterior approach videoneurosurgery. Anterior surgical techniques for cervical spondylotic myelopathy. Cervical corpectomy and fusion anterior approach youtube. Reimbursement questions nuvasive reimbursement guide the nuvasive reimbursement guide contains current spine arthrodesis procedure codes and descriptions. Oblique corpectomy for treatment of cervical spine epidural abscesses. The use of the cranial frame for navigated anterior craniocervical approaches as. This has well been demonstrated in our experience of 86 cases of spondylotic myelopathy treated by decompression with oblique corpectomy unpublished data.
The sympathetic chain was dissected free from under the prevertebral aponeurosis and retracted laterally. Metastatic cervical spine disease can be challenging to treat and has limited life expectancy and often multifocal disease. Since then, there is limited literature available on the results of oblique cervical corpectomy occ and although good clinical outcomes have been reported, and there is insufficient data with regard to the maintenance of sagittal alignment and preservation of cervical motion 1012, 15. Anterior surgical options for cervical spondylotic myelopathy.
Oblique corpectomy for treatment of cervical spine. Endoscopic partial cervical corpectomy opening a new door. Anterior cervical corpectomy and fusion accf is commonly performed to treat cervical spondylosis, cervical radiculopathy, or both. This procedure is known as the cervical corpectomy operation. Read multilevel oblique corpectomy for cervical spondylotic myelopathy preserves segmental motion, european spine journal on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Managing spondylotic cervical myeloradiculopathy using. Oblique cervical corpectomy occ is a lateral cervical approach used as an alternative to a central corpectomy, with the advantage of preserving motion since no fusion is performed.
The technique of oblique corpectomy has been reported for the first time in 1993 to access lesions developed in the anterior part of the spinal canal 1. The ap oblique cervical spine projections are supplementary views to the standard ap, odontoid and lateral cspine series. Pdf clinical and radiological outcomes in 153 patients. Pdf oblique corpectomy to manage cervical myeloradiculopathy. Pdf cervical corpectomy, fusion, and vertebral restoration. The majority of patients are satisfied with their pain relief and the results of their surgery. Oblique corpectomy for treatment of cervical spine epidural. Multilevel cervical oblique corpectomy andor lateral foraminotomy allow wide decompression of nervous structures, while maintaining optimal stability and physiological motion of the cervical spine. Clinicobiomechanical considerations on oblique corpectomy. The cervical spine was stabilized with an anterior plating c2c4. Limited oblique corpectomy for ossified posterior longitudinal ligament table 1. The tumor was completely resected with the edges free from disease. Figure 2 from oblique corpectomy to manage cervical.
Multilevel oblique corpectomy for cervical spondylotic myelopathy preserves segmental motion by a. We included 28 patients with preoperative and at least two serial followup neutral and dynamic cervical spine radiographs who underwent occ for csm. Oblique corpectomy oc is an alternative technique for the resection of spondylotic spurs ventral to the cervical spinal cord contributing to cervical spondylotic myelopathy csm and cervical spondylotic radiculopathy csr. May 26, 2016 to assess the longterm clinical and radiographic outcomes of anterior cervical corpectomy and fusion accf with a neotype nanohydroxyapatitepolyamide 66 nhapa66 strut in the treatment of. Cervical spine ap oblique view radiology reference. The multilevel oblique corpectomy moc allows widening of the spinal canal and foramen trough via an anterolateral access to the cervical spine with control of the vertebral artery and does not require vertebral stabilization or fusion. The oblique cervical corpectomy occ has slowly emerged as an established method of decompressing the spine in patients with cervical spondylotic myelopathy csm 410. Multilevel cervical oblique corpectomy andor lateral foraminotomy allow wide decompression of. Table summarizing the clinical features patient agesex preoperative duration extent of duration clinical grade at no. To document the neurological outcome, spinal alignment and segmental range of movement after oblique cervical corpectomy occ for cervical compressive myelopathy. Lateral mass fractures lateral mass fracture involves. Oblique corpectomy to manage cervical myeloradiculopathy. Cervical spondylotic myelopathy csm is one of the most common.
The value of intraoperative ultrasound in oblique corpectomy for cervical spondylotic myelopathy and ossified posterior longitudinal ligament. The best sleeping position for back pain, neck pain, and sciatica tips from a physical therapist duration. Two patients had severe medical comorbidities, and the third showed coexisting sclerosis multiplex. It is indicated in patients with a stable cervical spine and can be used for as many cervical levels as needed. Certainly, oblique corpectomy described and divulged by george may be an alternative for decompression without fusion in ankylosed spines. Limited oblique corpectomy for treatment of ossified posterior longitudinal ligament a goel 1, s pareikh 2 1 department of neurosurgery, king edward memorial hospital and seth gordhandas sunderdas medical college, parel, mumbai, india 2 lilavati hospital and research centre, bandra, mumbai, india. Anterior cervical corpectomy, with or without plating, has been reported to achieve high fusion rates, improvement in myelopathy, and good to excellent outcomes. Jan 11, 2012 to document the neurological outcome, spinal alignment and segmental range of movement after oblique cervical corpectomy occ for cervical compressive myelopathy.
565 713 1009 547 702 245 1142 1006 359 212 581 777 1269 1220 273 767 270 1294 803 1301 536 99 941 1534 1269 862 1199 110 934 92 1662 1157 1018 1292 1343 947 1013 941 806 177 735 341 696 265 728 734 205 971