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Japanese

A Less Invasive Technique for Removing Cervical Spinal Cord Tumors : Using Shiraishi's Posterior Approach Atsuo Kawakita 1 , Yoshiyuki Yato 1 , Hiroshi Yoshida 1 , Takeshi Ikegami 1 , Tateru Shiraishi 1 1Department of Orthopaedic Surgery, Saiseikai Utsunomiya Hospital Keyword: cervical spine , 頚椎 , less invasive surgery , 低侵襲手術 , spinal cord tumor , 頚髄腫瘍 pp.1187-1192
Published Date 2003/9/1
DOI https://doi.org/10.11477/mf.1408100799
  • Abstract
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 We describe a new technique for removing cervical spinal cord tumors that uses Shiraishi's posterior approach to the cervical spine, and we discuss its significance. The new technique was used to excise an Eden type 2 dumbbell-shaped neurinoma of the upper cervical spine.

 [Surgical technique]A longitudinal midline incision was made, and the deep extensor muscles and the spinous processes were exposed. After sagittaly splitting the C2 spinous process in the midline, the left lamina-facet junction of the C2 was divided to make a free fragment of the left half of the C2 posterior arch while preserving all five muscles that attached to the C2 spinous process. The fragment was retracted laterally to expose the intraspinal portion of the dumbbell tumor, and after removing the tumor, the fragment was replaced in its anatomical position and firmly sutured to its counterpart.

 The use of posterior approaches to remove cervical spinal cord tumors has the advantage of exposing the intraspinal space with less damage to the bony spine than by the anterior or anterolateral approaches. However, the deep extensor muscles that attach to the spinous processes are invariably neglected in conventional posterior approaches to the cervical spine, leading to postoperative problems such as cervical malalignment and axial symptoms. The procedure described here enabled preservation of the deep extensor musculature as a dynamic stabilizer of the cervical spine and reconstruction of the posterior bony arch anatomically as a static stabilizer. We consider this technique to be a useful alternative to conventional posterior methods, and it should be regarded as an approach of first choice when excision of a cervical spinal cord tumor is planned.


Copyright © 2003, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1286 印刷版ISSN 0557-0433 医学書院

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