Anatomical Importance Between Neural Structure and Bony Landmark: Clinical Importance for Posterior Endoscopic Cervical Foraminotomy
Objective Posterior endoscopic cervical foraminotomy (PECF) is a well-established, minimally invasive surgery for cervical radiculopathy, but have the more chances of neural structure damage due to the limited visibility and steeper learning curve. So, the anatomical understanding of the nerve assoc...
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| Format: | Article |
| Language: | English |
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Korean Spinal Neurosurgery Society
2021-03-01
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| Series: | Neurospine |
| Subjects: | |
| Online Access: | http://www.e-neurospine.org/upload/pdf/ns-2040440-220.pdf |
| _version_ | 1797334272077463552 |
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| author | Ji Yeon Kim Dae Hwan Kim Yeon Jin Lee Jun Bok Jeon Soo Yong Choi Hyeun Sung Kim Il-Tae Jang |
| author_facet | Ji Yeon Kim Dae Hwan Kim Yeon Jin Lee Jun Bok Jeon Soo Yong Choi Hyeun Sung Kim Il-Tae Jang |
| author_sort | Ji Yeon Kim |
| collection | DOAJ |
| description | Objective Posterior endoscopic cervical foraminotomy (PECF) is a well-established, minimally invasive surgery for cervical radiculopathy, but have the more chances of neural structure damage due to the limited visibility and steeper learning curve. So, the anatomical understanding of the nerve associated with the bony structure will be an essential surgical guideline. Methods We measured the distance between the bilateral dura lateral edge and bilateral V-point on axial cuts of cervical magnetic resonance imaging and 3-dimensional spine computed tomography imaging, respectively, from 80 patients. We then calculate the distance and position between the dura lateral edge and the V-point as surgically critical width (SCW). Transverse interdural distance (TIDW), transverse inter-V-point distance, and anatomical facet joint width were measured. Results The mean TIDW decreased as the levels down in the 40s–60s but increased at the C4–5, C5–6, and C6–7 levels in the 70s. Statistically significant difference was shown at the C6–7 level between the 40s and the 70s. The mean anatomical inter-V-point distance markedly decreased at C5–6 and continued till the C7–Tl level at all age groups. Moreover, a statistically significant difference was shown at the C3–4 and C4–5 level between the 40s and the 70s. The mean negative values of SCW increased from the 40s to 70s at the C5–6 and C6–7 levels (C5–6: -0.60 ± 1.10 mm to -1.63 ± 1.56 mm; C6–7: -0.90 ± 0.74 mm to -2.18 ± 1.25 mm). There were statistically significant differences between the 2 aged groups at the C3–4, C4–5, C5–6, and C6–7 levels. Conclusion A prediction of the correlated position between the lateral dura edge and the V-point is essential for the PECF not to injure the neural structure. In the case of a performing the PECF at the C5–6 and C6–7 level in the old-aged patient, it should be considered the laterally moved dura edge, and more extended bony remove is needed for less neural structure damage. |
| first_indexed | 2024-03-08T08:18:22Z |
| format | Article |
| id | doaj.art-6f743f8985a3444c9ae5f9f82bd41a7b |
| institution | Directory Open Access Journal |
| issn | 2586-6583 2586-6591 |
| language | English |
| last_indexed | 2024-03-08T08:18:22Z |
| publishDate | 2021-03-01 |
| publisher | Korean Spinal Neurosurgery Society |
| record_format | Article |
| series | Neurospine |
| spelling | doaj.art-6f743f8985a3444c9ae5f9f82bd41a7b2024-02-02T06:53:56ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912021-03-0118113914610.14245/ns.2040440.2201135Anatomical Importance Between Neural Structure and Bony Landmark: Clinical Importance for Posterior Endoscopic Cervical ForaminotomyJi Yeon Kim0Dae Hwan Kim1Yeon Jin Lee2Jun Bok Jeon3Soo Yong Choi4Hyeun Sung Kim5Il-Tae Jang6 Department of Neurosurgery, Nanoori Gangnam Hospital, Seoul, Korea Department of Neurosurgery, Nanoori Gangnam Hospital, Seoul, Korea Department of Neurosurgery, Nanoori Gangnam Hospital, Seoul, Korea Department of Neurosurgery, Nanoori Gangnam Hospital, Seoul, Korea Department of Neurosurgery, Nanoori Gangnam Hospital, Seoul, Korea Department of Neurosurgery, Nanoori Gangnam Hospital, Seoul, Korea Department of Neurosurgery, Nanoori Gangnam Hospital, Seoul, KoreaObjective Posterior endoscopic cervical foraminotomy (PECF) is a well-established, minimally invasive surgery for cervical radiculopathy, but have the more chances of neural structure damage due to the limited visibility and steeper learning curve. So, the anatomical understanding of the nerve associated with the bony structure will be an essential surgical guideline. Methods We measured the distance between the bilateral dura lateral edge and bilateral V-point on axial cuts of cervical magnetic resonance imaging and 3-dimensional spine computed tomography imaging, respectively, from 80 patients. We then calculate the distance and position between the dura lateral edge and the V-point as surgically critical width (SCW). Transverse interdural distance (TIDW), transverse inter-V-point distance, and anatomical facet joint width were measured. Results The mean TIDW decreased as the levels down in the 40s–60s but increased at the C4–5, C5–6, and C6–7 levels in the 70s. Statistically significant difference was shown at the C6–7 level between the 40s and the 70s. The mean anatomical inter-V-point distance markedly decreased at C5–6 and continued till the C7–Tl level at all age groups. Moreover, a statistically significant difference was shown at the C3–4 and C4–5 level between the 40s and the 70s. The mean negative values of SCW increased from the 40s to 70s at the C5–6 and C6–7 levels (C5–6: -0.60 ± 1.10 mm to -1.63 ± 1.56 mm; C6–7: -0.90 ± 0.74 mm to -2.18 ± 1.25 mm). There were statistically significant differences between the 2 aged groups at the C3–4, C4–5, C5–6, and C6–7 levels. Conclusion A prediction of the correlated position between the lateral dura edge and the V-point is essential for the PECF not to injure the neural structure. In the case of a performing the PECF at the C5–6 and C6–7 level in the old-aged patient, it should be considered the laterally moved dura edge, and more extended bony remove is needed for less neural structure damage.http://www.e-neurospine.org/upload/pdf/ns-2040440-220.pdfendoscopic spine surgeryposterior cervical foraminotomycervical spine anatomy |
| spellingShingle | Ji Yeon Kim Dae Hwan Kim Yeon Jin Lee Jun Bok Jeon Soo Yong Choi Hyeun Sung Kim Il-Tae Jang Anatomical Importance Between Neural Structure and Bony Landmark: Clinical Importance for Posterior Endoscopic Cervical Foraminotomy Neurospine endoscopic spine surgery posterior cervical foraminotomy cervical spine anatomy |
| title | Anatomical Importance Between Neural Structure and Bony Landmark: Clinical Importance for Posterior Endoscopic Cervical Foraminotomy |
| title_full | Anatomical Importance Between Neural Structure and Bony Landmark: Clinical Importance for Posterior Endoscopic Cervical Foraminotomy |
| title_fullStr | Anatomical Importance Between Neural Structure and Bony Landmark: Clinical Importance for Posterior Endoscopic Cervical Foraminotomy |
| title_full_unstemmed | Anatomical Importance Between Neural Structure and Bony Landmark: Clinical Importance for Posterior Endoscopic Cervical Foraminotomy |
| title_short | Anatomical Importance Between Neural Structure and Bony Landmark: Clinical Importance for Posterior Endoscopic Cervical Foraminotomy |
| title_sort | anatomical importance between neural structure and bony landmark clinical importance for posterior endoscopic cervical foraminotomy |
| topic | endoscopic spine surgery posterior cervical foraminotomy cervical spine anatomy |
| url | http://www.e-neurospine.org/upload/pdf/ns-2040440-220.pdf |
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