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New Approach for Cervical Foraminotomy That Preserves All Deep Extensor Muscles and Application to Other Cervical Surgeries Ryoma Aoyama 1 , Tateru Shiraishi 1 , Junichi Yamane 1 , Kazuya Kitamura 1 , Takeshi Arai 1 , Ukei Anazawa 1 , Hiraku Hotta 1 , Naobumi Asano 1 , Yoshihito Mochizuki 1 1Tokyo Dental College Ichikawa General Hospital, Department of Orthopaedic Surgery Keyword: 頚椎 , cervical , 椎間孔拡大術 , foraminotomy , 筋温存 , muscle preserve pp.437-442
Published Date 2010/5/25
DOI https://doi.org/10.11477/mf.1408101730
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 In 2002 we began performing cervical foraminotomy without detaching any of the deep extensor muscles except the interspinal muscles from the spinous processes by using a muscle-preserving posterior approach to the cervical spine. In September 2008, we modified the approach by preserving the attachment of the interspinal muscles as well, and we have successfully applied this modified approach to foraminotomy, laminoplasty, and lateral mass screw fixation. The key to success in this newly modified procedure is to divide the cervical prevertebral fascia to expose the underlying deep extensor musculature. So doing allows the surgeon to accurately identify each of the different muscles by examining the orientation of their muscle fibers. The laminae and intervertebral joint are exposed by bluntly enlarging the free space (ISS triangle) between the interspinal muscles and the adjacent upper and lower semispinalis cervicis muscles with a small nerve dissector. Current endoscopic surgeries of the posterior spine use an intra-muscular approach that involves splitting or partially removing muscle tissue, whereas the approach of our muscle-preserving exposure procedures is generally through the inter-muscular plane and is achieved by opening the free spaces among the different muscles without damaging their substance, instead of approaching through an intra-muscular plane. We think that modifying our previous exposure technique has enabled the concept of minimal invasiveness of the musculature to be completely achieved.


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

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