C-spine surgeries

Question 1

discectomy/microdiscectomy

Answer 1

-Remove all or part of a disc
-Arthroscopic and cut off bulge
-Minimally invasive

Question 2

laminoforaminotomy

Answer 2

-Indicated for lateral canal stenosis
-Remove whatever is causing impingement
-Typically shave part of lamina, remove osteophyte complex and then remove anything else that needs to be removed

Question 3

laminoplasty

Answer 3

-Indicated for central canal stenosis
-Restructure/reshape the lamina
-Essentially put in a spacer
-Give SC more room

Question 4

(partial) laminectomy

Answer 4

-Indicated for central canal stenosis OR multi-level lateral stenosis
-Usually posterior approach
-Removal of spinous process and BL laminae
- < 25% of z-joint removed (if need to remove more → fusion)

Question 5

Arthrodesis: Anterior Cervical Discectomy and Fusion (ACDF)

Answer 5

-Removal of structures causing compression on nerve tissue
-Prevents motion at disc level to improve stability

Question 6

When would an arthrodesis be indicated?

Answer 6

-Fracture
-Radiculopathy/radicular pain (if due to degeneration)
-Spondylolisthesis

Question 7

What is the biggest problem with an arthrodesis?

Answer 7

pts can develop degenerative pathology of adjacent levels due to the excessive motion required

Question 8

Cervical Disc Arthroplasty

Answer 8

-Cervical discectomy, then prosthetic is implanted into disc space
-Pt typically D/C within 24-48 hrs with minimal restrictions
-Usually anterior approach
-More common in military