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A Journal on Neurosurgery

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Journal of Neurosurgical Sciences 2016 Jul 07

language: English

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.

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