A Novel Technique for Cervical Facet Joint Hyperplasia-Spondylotic Radiculopathy by Laminar and Lateral Mass Screw Cofixations

World Neurosurg. 2018 Feb:110:e490-e495. doi: 10.1016/j.wneu.2017.11.018. Epub 2017 Nov 14.

Abstract

Objective: We sought to describe the novel technique and report the outcomes of cervical spondylotic radiculopathy caused by facet joint hyperplasia treated with minimally invasive surgery by laminar and lateral mass screw cofixations.

Method: In this retrospective study, patients with spondylotic radiculopathy caused by facet joint hyperplasia underwent this technique in our unit between January 2010 and June 2015. Hospital charts, magnetic resonance imaging studies, and follow-up records for all the patients were reviewed. Outcomes were assessed on the basis of neurologic status, magnetic resonance imaging, and visual analog scale for neck and radicular pain and by the short form-36 health survey questionnaire.

Results: Thirteen men and 5 women, aged 47-73 years (mean, 61.8 years), were included in this study. The follow-up time ranged from 19-50 months (mean, 32.4 months). The mean visual analog scale scores for radicular pain and neck pain, as well as the scores for all 8 domains of the short form-36 health survey questionnaire, showed significant improvements (P < 0.05). Cervical lordosis showed bending, whereas the height of the targeted disk segment showed no change (P > 0.05). Complications included 2 cases of neck pain that lasted for 3 months.

Conclusion: Minimally invasive surgery by lamina and lateral mass screw cofixation is safe and effective for the treatment of cervical spondylotic radiculopathy caused by facet joint hyperplasia. In addition to sufficient decompression, this technique provides relative stability to the cervical spine.

Keywords: Cervical spondylotic radiculopathy; Facet joint hyperplasia; Laminar screw; Lateral mass screw; Minimally invasive surgery.

MeSH terms

  • Aged
  • Bone Screws*
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperplasia / complications
  • Hyperplasia / diagnostic imaging
  • Hyperplasia / surgery
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures* / instrumentation
  • Minimally Invasive Surgical Procedures* / methods
  • Neck Pain / etiology
  • Pain, Postoperative
  • Radiculopathy / etiology
  • Radiculopathy / surgery*
  • Retrospective Studies
  • Spondylosis / diagnostic imaging
  • Spondylosis / etiology
  • Spondylosis / surgery*
  • Treatment Outcome
  • Zygapophyseal Joint / diagnostic imaging
  • Zygapophyseal Joint / pathology
  • Zygapophyseal Joint / surgery*