OBLIQUE TRANSCORPOREAL DRILLING TO TREAT ANTERIOR COMPRESSION OF THE SPINAL-CORD AT THE CERVICAL LEVEL

Oblique transcorporeal drilling is a new surgical technique in which t he transverse foramina with the vertebral artery and lateral aspects o f the bodies of the cervical vertebrae are exposed; it allows to drill out obliquely from the antero-lateral to the opposite postero-lateral corner, half of one or several cervical vertebral bodies. The techniq ue is shortly described and its indications are discussed. It can main ly be applied to release osteophytic compression and to remove anterio rly developed tumors. The advantages are to work in a wide field with all important structures kept medially and protected and to keep a suf ficient portion of the vertebral bodies to preserve the spine stabilit y. This technique has been used in 39 cases with spondylosis in 27 cas es, tumor in 11 cases and kyphosis in 2 cases including one with neuro fibroma. Results in term of decompression were excellent in all cases. Mortality was none and morbidity was limited to a transient Horner's syndrome in almost all cases and to a CSF leak in three cases, This te chnique is therefore alternative to the anterior transcorporeal approa ch. In our experience, the oblique transcorporeal drilling provides a wider and safer access to lesions located anterior to the spinal cord.