[Cervical spondylosis. Resection by oblique transcorporeal approach]

Spondylosis at the cervical level inducing anterior spinal cord compression is generally treated by anterior transcorporeal resection of the osteophytic spurs. We report on 12 cases over 2 years in which a new technique has been applied; it uses the lateral approach exposing and retracting laterally the vertebral artery; then, the vertebral bodies are drilled out obliquely from the anterolateral corner to the posterolateral one on the opposite side. The vertebral bodies were drilled using this technique on 1 level in 2 cases, on 2 levels in 4, on 3 levels in 5 and on 4 levels in 1; the C4-C5, C5-C6 and C6-C7 levels were the most frequent sites involved in 9, 8 and 6 cases respectively. No graft or arthrodesis was used since the stability of the spine was never compromised. Improvement of the neurological symptoms was observed in all the cases with the best results achieved on the motor deficit and sphincter disturbances. Every case was controlled by dynamic standard radiographies (flexion-extension), CT scan and MRI. The results were good in all cases in terms of osteophytes resection, spinal cord decompression and spinal stability. This technique of oblique resection of the cervical bodies seems quite efficient to alleviate spondylotic compression of the spinal cord; moreover, it appears simpler and safer than the anterior route since the operative field is much wider with all the vital structures protected and retracted medially and bone grafting is never necessary.