Microscopic Cervical Spine Surgery
Microscopic Cervical Spine Surgeries
Cervical spine surgeries are routinely done procedures in spine surgery practice. With the addition of the surgical microscope while doing the cervical spine procedures, there is enhanced visualization of the microanatomy which allows safe and efficient treatment of the disease.
It is important for the spine surgeon to understand the critical steps required to successfully treat cervical spine pathology with the assistance of a surgical microscope, the factors involved in choosing a particular method, the technical considerations, and the use of instrumentations.
The knowledge of surgical pearls may optimize spinal cord and nerve root decompression, increase fusion rates, and give patients the best chance for a successful clinical outcome.
A variety of surgical approaches available for cervical spine, that can be done under microscope, including anterior cervical discectomy and fusion (ACDF), anterior cervical corpectomy and fusion (ACCF), artificial disc replacement, single open-door or double-door laminoplasty, laminectomy, and laminectomy with fusion. These are grossly divided as anterior and posterior surgeries, each having its own indications.
The microscope-assisted anterior approach helps in better visualization of the surgical field and avoids incomplete decompression.
The posterior approach mostly uses the tubular retractors to completely remove the ligamentum flavum compression, without the need for wide laminectomy, thus avoiding spinal instability. However, the use of microscopes and tubular retractors necessitates additional learning of microsurgical manipulation techniques, spinal anatomy, and spinal mechanics.
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