Anterior selective scalenectomy for periforaminal exposure in the ventral supraclavicular approach
Aims and Objectives: Route of choice to access cervical paravertebral lesions with foraminal involvement is the anterolateral corridor with its variants. Main limitation of these techniques is represented by the limited surgical access to periforaminal area due to the bulk generated by the anterior...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Journal of Craniovertebral Junction and Spine |
| Subjects: | |
| Online Access: | http://www.jcvjs.com/article.asp?issn=0974-8237;year=2023;volume=14;issue=2;spage=144;epage=148;aulast=Gagliardi |
| _version_ | 1797773977026822144 |
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| author | Filippo Gagliardi Marzia Medone Leone Giordano Silvia Snider Martina Piloni Edoardo Pompeo Francesca Roncelli Luca Ruffino Pietro Mortini |
| author_facet | Filippo Gagliardi Marzia Medone Leone Giordano Silvia Snider Martina Piloni Edoardo Pompeo Francesca Roncelli Luca Ruffino Pietro Mortini |
| author_sort | Filippo Gagliardi |
| collection | DOAJ |
| description | Aims and Objectives: Route of choice to access cervical paravertebral lesions with foraminal involvement is the anterolateral corridor with its variants. Main limitation of these techniques is represented by the limited surgical access to periforaminal area due to the bulk generated by the anterior scalene muscle (ASM). Over the years, alternative techniques for ASM surgical management have been developed, which are still today a matter of debate. Most popular include ASM scalene complete section (SCS) and ASM medial detachment (SMD). Authors describe an innovative, minimally invasive muscle section technique, the anterior selective scalenectomy (ASS), which reduces the risk of iatrogenic morbidity and optimizes exposure of periforaminal area in anterolateral cervical routes.
Materials and Methods: A laboratory investigation was conducted. Technique was applied in a surgical setting, and an illustrative case was reported.
Results: ASS is a quick and easy technique to perform. It allows optimization of surgical visibility and control on the periforaminal area in the cervical anterolateral corridor. It respects muscle anatomy and vascularization, favoring functional recovery and management of peri-operative pain; it reduces the risk of morbidity on phrenic nerve and pleura. Considering the minimally invasive nature of the technique, it allows for a slightly more limited exposure compared to traditional techniques while ensuring optimal surgical maneuverability on the target area.
Conclusions: ASS represents an effective and safe alternative to traditional ASM section techniques for the exposure of periforaminal area in anterolateral cervical routes. It is indicated in case of lesions with paravertebral development and minimal intraforaminal component in the C3-C6 segment. |
| first_indexed | 2024-03-12T22:14:23Z |
| format | Article |
| id | doaj.art-c676679d8fe14a0d83b549b0ea3e9246 |
| institution | Directory Open Access Journal |
| issn | 0974-8237 |
| language | English |
| last_indexed | 2024-03-12T22:14:23Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Craniovertebral Junction and Spine |
| spelling | doaj.art-c676679d8fe14a0d83b549b0ea3e92462023-07-23T11:24:02ZengWolters Kluwer Medknow PublicationsJournal of Craniovertebral Junction and Spine0974-82372023-01-0114214414810.4103/jcvjs.jcvjs_153_22Anterior selective scalenectomy for periforaminal exposure in the ventral supraclavicular approachFilippo GagliardiMarzia MedoneLeone GiordanoSilvia SniderMartina PiloniEdoardo PompeoFrancesca RoncelliLuca RuffinoPietro MortiniAims and Objectives: Route of choice to access cervical paravertebral lesions with foraminal involvement is the anterolateral corridor with its variants. Main limitation of these techniques is represented by the limited surgical access to periforaminal area due to the bulk generated by the anterior scalene muscle (ASM). Over the years, alternative techniques for ASM surgical management have been developed, which are still today a matter of debate. Most popular include ASM scalene complete section (SCS) and ASM medial detachment (SMD). Authors describe an innovative, minimally invasive muscle section technique, the anterior selective scalenectomy (ASS), which reduces the risk of iatrogenic morbidity and optimizes exposure of periforaminal area in anterolateral cervical routes. Materials and Methods: A laboratory investigation was conducted. Technique was applied in a surgical setting, and an illustrative case was reported. Results: ASS is a quick and easy technique to perform. It allows optimization of surgical visibility and control on the periforaminal area in the cervical anterolateral corridor. It respects muscle anatomy and vascularization, favoring functional recovery and management of peri-operative pain; it reduces the risk of morbidity on phrenic nerve and pleura. Considering the minimally invasive nature of the technique, it allows for a slightly more limited exposure compared to traditional techniques while ensuring optimal surgical maneuverability on the target area. Conclusions: ASS represents an effective and safe alternative to traditional ASM section techniques for the exposure of periforaminal area in anterolateral cervical routes. It is indicated in case of lesions with paravertebral development and minimal intraforaminal component in the C3-C6 segment.http://www.jcvjs.com/article.asp?issn=0974-8237;year=2023;volume=14;issue=2;spage=144;epage=148;aulast=Gagliardibrachial plexuscervical anterolateral approachcervical paravertebral tumorsscalenectomyventral supraclavicular approach |
| spellingShingle | Filippo Gagliardi Marzia Medone Leone Giordano Silvia Snider Martina Piloni Edoardo Pompeo Francesca Roncelli Luca Ruffino Pietro Mortini Anterior selective scalenectomy for periforaminal exposure in the ventral supraclavicular approach Journal of Craniovertebral Junction and Spine brachial plexus cervical anterolateral approach cervical paravertebral tumors scalenectomy ventral supraclavicular approach |
| title | Anterior selective scalenectomy for periforaminal exposure in the ventral supraclavicular approach |
| title_full | Anterior selective scalenectomy for periforaminal exposure in the ventral supraclavicular approach |
| title_fullStr | Anterior selective scalenectomy for periforaminal exposure in the ventral supraclavicular approach |
| title_full_unstemmed | Anterior selective scalenectomy for periforaminal exposure in the ventral supraclavicular approach |
| title_short | Anterior selective scalenectomy for periforaminal exposure in the ventral supraclavicular approach |
| title_sort | anterior selective scalenectomy for periforaminal exposure in the ventral supraclavicular approach |
| topic | brachial plexus cervical anterolateral approach cervical paravertebral tumors scalenectomy ventral supraclavicular approach |
| url | http://www.jcvjs.com/article.asp?issn=0974-8237;year=2023;volume=14;issue=2;spage=144;epage=148;aulast=Gagliardi |
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