B. George et G. Lot, OBLIQUE TRANSCORPOREAL DRILLING TO TREAT ANTERIOR COMPRESSION OF THE SPINAL-CORD AT THE CERVICAL LEVEL, Minimally invasive neurosurgery, 37(2), 1994, pp. 48-52
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.