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JOURNAL OF NEUROSURGICAL SCIENCES
A Journal on Neurosurgery
Indexed/Abstracted in: e-psyche, EMBASE, PubMed/MEDLINE, Neuroscience Citation Index, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,651
Journal of Neurosurgical Sciences 2016 Jul 07
Reappraisal of the posterior approach for cervical decompressive herniectomy
Susanna BACIGALUPPI 1, 2, Nicola L. BRAGAZZI 3, Samis ZELLA 1, Francesco PRADA 1, Mario L. ZAVANONE 1, Paolo RAMPINI 1 ✉
1 Neurosurgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Università degli Studi, Milano, Italy; 2 Neurosurgery, E.O. Ospedali Galliera, Genova, Italy; 3 School of Public Health, Department of Health Sciences (DISSAL), University of Genova, Genova, Italy
BACKGROUND: Does posterior cervical herniectomy impact on symptoms related to cervical paramedian/lateral soft disc herniation?
METHODS: In a patient series over 15 years operated for single level paramedian/lateral soft disc herniation with posterior cervical approach, perceived radicular and cervical pre- and post-operative symptoms were reconstructed and analyzed.
RESULTS: Out of 105 patients with these characteristics 75 could be recruited for long-term follow-up. Preoperative symptoms included: radicular motor deficit (81.3%); radicular pain (93.3%); radicular sensory deficit (84%); cervical pain (80%) and disturbance of cervical motility (49.3%). Postoperatively radicular motor score improved in all patients (score 5 in 92% and 4 in 8%); sensory disturbance improved in all and radicular pain disappeared in 90% and improved in the others. Cervical pain disappeared in 78% and improved in other 22%, two had new onset moderate cervical pain.
CONCLUSIONS: This series confirms safety and efficacy of the posterior approach in relieving motor and sensory symptoms in patients with symptomatic single level, lateral soft disc herniation.