, discectomy, and lateral recess decompression can all be accomplished using the transforaminal trajectory.
After the spinal level was determined again with fluoroscopy, secondary stenosis and foraminal stenosis were treated using Kerrison Rong or ultrasonic bone shaver and then total laminectomy and bilateral foraminotomy
Cervical endoscopic versus open foraminotomy
for uncovertebral lateral stenosis.
Those using this position identified its main indications as pineal surgery 42.9%, cervical foraminotomy
28.6% and posterior fossa surgery 28.6%.
Left sided [L.sub.4-5] microdiscectomy was performed after partial hemilaminectomy and foraminotomy
. The disc was degenerated and black in color (Figure 3).
Bilateral L5 and S1 roots wide foraminotomy
was done, especially concerning far lateral exposure of L5 roots, and was followed by bilateral L5-S1 discectomy.
Bony removal was intentionally generous because the sequestration was voluminous and the risk of performing incidental tractions or surgical traumas on nerve roots was high; furthermore, left L3 nerve root foraminotomy
and adhesiolysis were difficult to perform with a standard approach for a simple L2-L3 discectomy (Figure 2).
Additional surgical approaches arising from posterior and anterior access have also been explored, such as anterior cervical decompression without fusion, anterior foraminotomy
, posterior microscope-assisted or endoscope assisted "keyhole foraminotomy
," and cervical disc replacement [6,7].
This new code covers endoscopic decompression of the spinal cord, nerve root(s), including laminotomy, partial facetectomy, foraminotomy
, discectomy and/or excision of herniated intervertebral disc, 1 interspace, lumbar, and will be enforced as of January 1st, 2017.
Whereas patients with chronic spinal stenosis opt for surgical procedures such as laminectomy, corpectomy foraminotomy
Interlaminar discectomy with foraminotomy
can produce the same, if not better results with less post-operative morbidity.
Neurosurgeons and orthopedic surgeons from the US, Asia, Brazil, New Zealand, and Canada offer 11 chapters that outline techniques like laminoplasty, anterior procedures, pedicle screw fixation, laminectomy and fusion, posterior foraminotomy
, arthroplasty, and occipitocervical fixation, with pearls and pitfalls, and additional chapters on methods for avoiding complications, the use of navigation in cervical spine surgery, sagittal alignment, and adjacent segment pathology and its relationship to surgical procedures.