Cervical Cordotomy via Anterior Approach without Bone Graft.
- Author:
Heuyng Keun KIM
1
;
Jong Sik KIM
;
Suk Jun OH
;
Yung Rak YOO
;
Nam Kyu KIM
;
Hwan Yung CHUNG
Author Information
1. Department of Neurosurgery, School of Medicine, Hanyang University, Seoul, Korea.
- Publication Type:Original Article
- MeSH:
Brachial Plexus;
Cordotomy*;
Diskectomy;
Dura Mater;
Gelatin Sponge, Absorbable;
Incidence;
Laminectomy;
Lower Extremity;
Mortality;
Pain, Intractable;
Sensation;
Spinothalamic Tracts;
Traction;
Transplants*;
Urinary Bladder
- From:Journal of Korean Neurosurgical Society
1977;6(2):469-476
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Cervical cordotomy via anterior approach without bone graft which is a modified Cloward's method is an effective and simple means of relieving of intractable pain with minimal destruction of bone lower morbidity and mortality. This method consists of an anterior surgical approach to the ventral surface of the cervical cord through a simple discectomy. A transverse incision in the dura mater gives excellent exposure permitting incision of the spinothalamic tracts under direct vision. For bilateral pain both incision are made at the same level of the cord without causing impairment of motor function of the lower extremities or bowel and bladder. This procedure has also many advantages and disavantages as follows ; 1. Cervical cordotomy by the this procedure has a much lower morbidity and fewer complications than the conventional procedure by laminectomy. 2. A more complete section of the spinothalamic tract is possible under direct vision. 3. A differential section of the tract with sparing of sensation in non-painful areas is possible by this procedure. 4. An incidence of the cord trauma can be minimized because the incision is possible without distorsion and traction of the cord during the operation. 5. This procedure without bone graft is simpler than original Cloward's method. 6. An water-tight closure of the dura is difficult but successful results are obtained by using a gelfoam. 7. This procedure above the level of the C3-4 interspace is difficult but possible. 8. A relief of pain below the level of the T3 dermatome is available and there is no good operative candidate when the brachial plexus is involved.
