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- Title
Minimally Invasive Approach to the Cervical Spine: A Proposal.
- Authors
Miccoli, Paolo; Berti, Piero; Raffaelli, Marco; Materazzi, Gabriele; Conte, Massimo; Faldini, Alessandro
- Abstract
Background and Purpose: During the last 3 years, a minimally invasive video-assisted approach for parathyroidectomy and thyroidectomy has been developed. Because of the good exposure of the cervical spine during these procedures, the authors decided to perform an anatomic-radiologic study in order to evaluate which cervical vertebrae could be reached by this minimally invasive approach. Patients and Methods: Three consenting patients, two undergoing minimally invasive parathyroidectomy and one a conventional operation for C[sub 4]-C[sub 5] disc herniation, were selected for this study. The procedure was carried out through a single 1.5-cm central skin incision above the sternal notch. After opening of the cervical linea alba, dissection was performed under endoscopic vision, without using any CO[sub 2] insufflation or trocar. After exposure of the prevertebral fascia, an operative tube was introduced through the cervical incision in order to maintain the operative space without using conventional retractors. Results: Through this operative tube, it was possible to introduce both a 5-mm (or 3-mm) endoscope and the surgical instruments. In our patients, we inserted a 1-mm metal probe to exactly localize during fluoroscopy the vertebrae reached by the dissection (C[sub 2]-C[sub 7]). Conclusions: This study shows the feasibility of an anterior minimally invasive approach to the cervical spine. Although the exact indications have to be verified, a video-assisted approach could add some advantages to the well-known benefits coming from the anterior approaches to the cervical spine, especially in terms of cosmetic results and postoperative course and recovery.
- Subjects
CERVICAL vertebrae; SURGERY
- Publication
Journal of Laparoendoscopic & Advanced Surgical Techniques, 2001, Vol 11, Issue 2, p89
- ISSN
1092-6429
- Publication type
Article
- DOI
10.1089/109264201750162338