Acta Ortopédica Mexicana

Braulio Hernández Carbajal
Percutaneous cervical arthrodesis. Original technique
Acta Ortop Mex 2003; 17 (5)

Language: Español
References: 20
Page: 205-210
PDF: 143.86 Kb.

[Fulltext - PDF]

ABSTRACT

The instruments for an original technique of percutaneous cervical arthrodhesis (PCA) under local anesthesia and soothing, and the technique itself are reported here. The procedure is ambulatory and it can be performed in the operating theater or in the x-ray room. It is reported the two-year evolution for the first seven patients given this treatment, four from the female sex and three from the male one, ranging from 36 and 68 years old. These patients had been diagnosed as presenting single or multiple disk hernia with a relapse to percutaneous nucleotomy embracing less than 25% of the vertebral groove, disk hernia with spine instability or discarthrosis. The patients suffering from medullar compression, non-reducible spondylolisthesis or progressive neuropathy were discarded from this study. The results were satisfactory in six patients (85.7%) with pain having disappeared, neurological recovery and activity return at two weeks after the treatment. The result was not so satisfactory in one case due to grafting reabsorption, which led to a new open surgery. There were just a few problems and they consisted of pharyngitis and dysphagia presented by three patients after the immediate post-operative period and they were inherent in trachea, pharynx and esophagus manipulation, with a complete recovery in a maximum of three weeks. We recommend practicing this technique in patients who have been diagnosed single cervical disk hernia or when it is present along with discarthrosis and/or reducible instability, engaging at most two levels. We have some prudence or caution in level C2-C3.


Key words: cervical vertebrae, arthrodesis, nucleotomy percutaneus, therapeutics.


REFERENCES

  1. Cloward RB: Vertebral body fusion for rupture cervical discs. Am J Surg 1959; 98: 722-727.

  2. Connolly PJ, Esses SI, Kostuik JP: Anterior cervical fusion: outcome analysis of patients fused with and without cervical plates. J Spinal Disord 1996; 9(3): 202-206.

  3. Drew B, Bhandari M, Orr D, Reddy K, Dunlop RB: Surgical preference in anterior cervical discectomy: A national survey of Canadian Spine Surgeons. J Spinal Disord Tech 2002; 15(6): 454-457.

  4. Hijikata S: Percutaneous nucleotomy: A new concept technique and 12 years experience Clin Orthop 1989; 238: 9-23.

  5. Hijikata S, Yamagishi M, Nakayama T, Oomoti K: Percutaneous nucleotomy: A new treatment method lumbar disc herniation. J Toden Hosp 1975; 5: 5-13.

  6. Kambin P, Sampson S: Postelolateral percutaneous suction-excision of herniated lumbar invertebral discs. Report of interim results. Clin Orthop 1986; 207: 37-43.

  7. Kambin P: Posterolateral Percutaneous lumbar discectomy and decompression. Arthroscopic Microdiscectomy, Baltimore, Urban & Schwarzengberg, 1990: 67-98.

  8. Leu HF, Hauser RK: Percutaneous posterolateral foraminoscopy: principle technique and experience since 1991. Arthroskopie 1996; 9: 26-31.

  9. Leu H, Hauser R, Schreiber A: Percutaneous lumbar spine fusion. Acta Orthop Scand 1993; 251: 116-119.

  10. Leu Hj, Schreiber A: Fusion intersomatique lombaire par voie percutanée avec fixateúr externe temporaire. Rev Med Orthop 1991; 26: 9-12.

  11. Leu Hj, Schreiber A: Percutaneous fusion of the lumbar spine: A promising technique. Spine. State of the art reviews on spinal fusion, Philadelphia, Hanley & Belfus, 1992: 593-604.

  12. Leu HJF, Hauser RK: Percutaneous endoscopic lumbar spine fusion. Neurosurg Clin North Am 1996; 7(1): 107-117.

  13. Monteiro A: Artrodesis lumbar percutánea: Presentada en el 1er. Curso de Cirugía Percutánea en México, 1993.

  14. Onik G, Helms CA, Ginsburg L, Hoaglund FT, Morris J: Percutaneous lumbar discectomy using a news aspiration probe. Am J Roentgenol 1985; 144(6): 1137-1140.

  15. Onik G, Mooney V, Maroon JC, Wiltse L, Helms C, Schweigel J, Watkins R, Kahanovitz N, Day A, Morris J, Mc.Cullough JA, Reicher M, Croissant P, Dunsker S, Davis JW, Brown C, Hochschuler S, Saul T, Ray C: Automated percutaneous discectomy: A prospective multi-institutional study. Neurosurgery 1990; 26(2): 228-232.

  16. Schreiber A, Suezawa Y: Transdiscoscopic percutaneous nucleotomy in disc herniation. Orthop Rev 1986; 15(1): 35-38.

  17. Schreiber A, Suezawa Y, Leu H: Does percutaneous nucleotomy with discoscopy replace conventional diskectomy? Eight years of experience and results in treatment of herniated lumbar disc. Clin Orthop 1989; 238: 35-42.

  18. Tajima T: Discectomy cervical percutaneous Bruselles. Ann Radiol 1989: 32-316.

  19. Theron J, Hazebroucq V, Courtheoux F: Intradiscal injections of a long-lasting steroid (hexatrione) in the treatment of cervicobrachial neuralgias by disc herniations. Rachis 1989; 1: 351-358.

  20. Theron J, Huet H, Courtheoux F: Percutaneous automated cervical discectomy. Rachis 1992; 4: 93-105.