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Posterior Cervical Approach
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Pre-Procedure

      TERMINOLOGY

      • Definitions

        • Posterior approach with laminectomy, laminotomy, or laminoplasty
        • Useful for treatment of
          • Ossification of posterior longitudinal ligament (OPLL) with cervical lordosis
          • Multilevel cervical spondylosis
          • Soft disc herniation

      PRE-PROCEDURE

      • Indications

        • Contraindications

          OUTCOMES

          • Problems

            Selected References

            1. Franzini A et al: Minimally invasive disc preserving surgery in cervical radiculopathies: the posterior microscopic and endoscopic approach. Acta Neurochir Suppl. 108:197-201, 2011
            2. Highsmith JM et al: Treatment of cervical stenotic myelopathy: a cost and outcome comparison of laminoplasty versus laminectomy and lateral mass fusion. J Neurosurg Spine. 14(5):619-25, 2011
            3. Shin JH et al: Dorsal versus ventral surgery for cervical ossification of the posterior longitudinal ligament: considerations for approach selection and review of surgical outcomes. Neurosurg Focus. 30(3):E8, 2011
            4. Sinha S et al: Bilateral open-door expansive laminoplasty using unilateral posterior midline approach with preservation of posterior supporting elements for management of cervical myelopathy and radiculomyelopathy--analysis of clinical and radiological outcome and surgical technique. Acta Neurochir (Wien). 153(5):975-84, 2011
            5. Kunert P et al: Posterior microlaminoforaminotomy for cervical disc herniation. Neurol Neurochir Pol. 44(4):375-84, 2010
            6. Chen Y et al: Diagnosis and surgery of ossification of posterior longitudinal ligament associated with dural ossification in the cervical spine. Eur Spine J. 18(10):1541-7, 2009
            7. Kotani Y et al: Minimum 2-year outcome of cervical laminoplasty with deep extensor muscle-preserving approach: impact on cervical spine function and quality of life. Eur Spine J. 18(5):663-71, 2009
            8. Cağlar YS et al: Keyhole approach for posterior cervical discectomy: experience on 84 patients. Minim Invasive Neurosurg. 50(1):7-11, 2007
            9. Rhee JM et al: Cervical radiculopathy. J Am Acad Orthop Surg. 15(8):486-94, 2007
            10. Korinth MC et al: Posterior foraminotomy or anterior discectomy with polymethyl methacrylate interbody stabilization for cervical soft disc disease: results in 292 patients with monoradiculopathy. Spine (Phila Pa 1976). 31(11):1207-14; discussion 1215-6, 2006
            11. O'Toole JE et al: Endoscopic posterior cervical foraminotomy and discectomy. Neurosurg Clin N Am. 17(4):411-22, 2006
            12. Irwin ZN et al: Variation in surgical decision making for degenerative spinal disorders. Part II: cervical spine. Spine (Phila Pa 1976). 30(19):2214-9, 2005
            13. Russell SM et al: Posterior surgical approach to the cervical neural foramen for intervertebral disc disease. Neurosurgery. 54(3):662-5; discussion 665-6, 2004
            14. Boehm H et al: A new minimally invasive posterior approach for the treatment of cervical radiculopathy and myelopathy: surgical technique and preliminary results. Eur Spine J. 12(3):268-73, 2003
            15. Wang MY et al: Laminoplasty for the treatment of failed anterior cervical spine surgery. Neurosurg Focus. 15(3):E7, 2003
            16. Rodrigues MA et al: Posterior approach for soft cervical disc herniation: a neglected technique? Surg Neurol. 55(1):17-22; discussion 22, 2001
            17. Witzmann A et al: Posterior cervical foraminotomy. A follow-up study of 67 surgically treated patients with compressive radiculopathy. Neurosurg Rev. 23(4):213-7, 2000
            18. Lee TT et al: Modified open-door cervical expansive laminoplasty for spondylotic myelopathy: operative technique, outcome, and predictors for gait improvement. J Neurosurg. 86(1):64-8, 1997
            19. Epstein NE: Advanced cervical spondylosis with ossification into the posterior longitudinal ligament and resultant neurologic sequelae. J Spinal Disord. 9(6):477-84, 1996
            Related Anatomy
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            Related Differential Diagnoses
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            References
            Tables

            Tables

            KEY FACTS

            • Terminology

              • Pre-Procedure

                TERMINOLOGY

                • Definitions

                  • Posterior approach with laminectomy, laminotomy, or laminoplasty
                  • Useful for treatment of
                    • Ossification of posterior longitudinal ligament (OPLL) with cervical lordosis
                    • Multilevel cervical spondylosis
                    • Soft disc herniation

                PRE-PROCEDURE

                • Indications

                  • Contraindications

                    OUTCOMES

                    • Problems

                      Selected References

                      1. Franzini A et al: Minimally invasive disc preserving surgery in cervical radiculopathies: the posterior microscopic and endoscopic approach. Acta Neurochir Suppl. 108:197-201, 2011
                      2. Highsmith JM et al: Treatment of cervical stenotic myelopathy: a cost and outcome comparison of laminoplasty versus laminectomy and lateral mass fusion. J Neurosurg Spine. 14(5):619-25, 2011
                      3. Shin JH et al: Dorsal versus ventral surgery for cervical ossification of the posterior longitudinal ligament: considerations for approach selection and review of surgical outcomes. Neurosurg Focus. 30(3):E8, 2011
                      4. Sinha S et al: Bilateral open-door expansive laminoplasty using unilateral posterior midline approach with preservation of posterior supporting elements for management of cervical myelopathy and radiculomyelopathy--analysis of clinical and radiological outcome and surgical technique. Acta Neurochir (Wien). 153(5):975-84, 2011
                      5. Kunert P et al: Posterior microlaminoforaminotomy for cervical disc herniation. Neurol Neurochir Pol. 44(4):375-84, 2010
                      6. Chen Y et al: Diagnosis and surgery of ossification of posterior longitudinal ligament associated with dural ossification in the cervical spine. Eur Spine J. 18(10):1541-7, 2009
                      7. Kotani Y et al: Minimum 2-year outcome of cervical laminoplasty with deep extensor muscle-preserving approach: impact on cervical spine function and quality of life. Eur Spine J. 18(5):663-71, 2009
                      8. Cağlar YS et al: Keyhole approach for posterior cervical discectomy: experience on 84 patients. Minim Invasive Neurosurg. 50(1):7-11, 2007
                      9. Rhee JM et al: Cervical radiculopathy. J Am Acad Orthop Surg. 15(8):486-94, 2007
                      10. Korinth MC et al: Posterior foraminotomy or anterior discectomy with polymethyl methacrylate interbody stabilization for cervical soft disc disease: results in 292 patients with monoradiculopathy. Spine (Phila Pa 1976). 31(11):1207-14; discussion 1215-6, 2006
                      11. O'Toole JE et al: Endoscopic posterior cervical foraminotomy and discectomy. Neurosurg Clin N Am. 17(4):411-22, 2006
                      12. Irwin ZN et al: Variation in surgical decision making for degenerative spinal disorders. Part II: cervical spine. Spine (Phila Pa 1976). 30(19):2214-9, 2005
                      13. Russell SM et al: Posterior surgical approach to the cervical neural foramen for intervertebral disc disease. Neurosurgery. 54(3):662-5; discussion 665-6, 2004
                      14. Boehm H et al: A new minimally invasive posterior approach for the treatment of cervical radiculopathy and myelopathy: surgical technique and preliminary results. Eur Spine J. 12(3):268-73, 2003
                      15. Wang MY et al: Laminoplasty for the treatment of failed anterior cervical spine surgery. Neurosurg Focus. 15(3):E7, 2003
                      16. Rodrigues MA et al: Posterior approach for soft cervical disc herniation: a neglected technique? Surg Neurol. 55(1):17-22; discussion 22, 2001
                      17. Witzmann A et al: Posterior cervical foraminotomy. A follow-up study of 67 surgically treated patients with compressive radiculopathy. Neurosurg Rev. 23(4):213-7, 2000
                      18. Lee TT et al: Modified open-door cervical expansive laminoplasty for spondylotic myelopathy: operative technique, outcome, and predictors for gait improvement. J Neurosurg. 86(1):64-8, 1997
                      19. Epstein NE: Advanced cervical spondylosis with ossification into the posterior longitudinal ligament and resultant neurologic sequelae. J Spinal Disord. 9(6):477-84, 1996