Oblique transcorporeal drilling to treat anterior compression of the spinal cord at the cervical level.
Oblique transcorporeal drilling is a new surgical technique in which the transverse foramina with the vertebral artery and lateral aspects of the bodies of the cervical vertebrae are exposed; it allows to drill out obliquely from the antero-lateral to the opposite postero-lateral corner, half of one or several cervical vertebral bodies. The technique is shortly described and its indications are discussed. It can mainly be applied to release osteophytic compression and to remove anteriorly developed tumors. The advantages are to work in a wide field with all important structures kept medially and protected and to keep a sufficient portion of the vertebral bodies to preserve the spine stability. This technique has been used in 39 cases with spondylosis in 27 cases, tumor in 11 cases and kyphosis in 2 cases including one with neurofibroma. Results in term of decompression were excellent in all cases. Mortality was none and morbidity was limited to a transient Horner's syndrome in almost all cases and to a CSF leak in three cases. This technique is therefore alternative to the anterior transcorporeal approach. In our experience, the oblique transcorporeal drilling provides a wider and safer access to lesions located anterior to the spinal cord.
George
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Department of Neurosurgery, Lariboisiere Hospital, Paris, France.
Lot
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D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009455:Neurofibroma / Q000175:diagnosis / Q000601:surgery; D009456:Neurofibromatosis 1 / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000601:surgery*; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D013128:Spinal Osteophytosis / Q000175:diagnosis / Q000601:surgery*