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A Comparative Study on the Minimal Invasiveness of Full-Endoscopic and Microendoscopic Cervical Foraminotomy Using Intraoperative Motor Evoked Potential Monitoring

Background and Objectives: Full-endoscopic cervical foraminotomy (FECF) and microendoscopic cervical foraminotomy (MECF) are effective surgeries for cervical radiculopathy and are considered minimally invasive in terms of damage to paraspinal soft tissue. However, no studies have quantitatively comp...

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Autores principales: Hirahata, Masahiro, Kitagawa, Tomoaki, Fujita, Muneyoshi, Shiboi, Ryutaro, Kawano, Hirotaka, Iwai, Hiroki, Inanami, Hirohiko, Koga, Hisashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7698079/
https://www.ncbi.nlm.nih.gov/pubmed/33187319
http://dx.doi.org/10.3390/medicina56110605
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author Hirahata, Masahiro
Kitagawa, Tomoaki
Fujita, Muneyoshi
Shiboi, Ryutaro
Kawano, Hirotaka
Iwai, Hiroki
Inanami, Hirohiko
Koga, Hisashi
author_facet Hirahata, Masahiro
Kitagawa, Tomoaki
Fujita, Muneyoshi
Shiboi, Ryutaro
Kawano, Hirotaka
Iwai, Hiroki
Inanami, Hirohiko
Koga, Hisashi
author_sort Hirahata, Masahiro
collection PubMed
description Background and Objectives: Full-endoscopic cervical foraminotomy (FECF) and microendoscopic cervical foraminotomy (MECF) are effective surgeries for cervical radiculopathy and are considered minimally invasive in terms of damage to paraspinal soft tissue. However, no studies have quantitatively compared FECF and MECF in terms of neurological invasiveness. The aim of this study was to compare the neurological invasiveness of FECF and MECF using intraoperative motor evoked potential (MEP) monitoring. Materials and Methods: A chart review was conducted of 224 patients with cervical radiculopathy who underwent FECF or MECF between April 2014 and March 2020. Patients were 37 women and 187 men, with a mean age of 51 (range, 21–86) years. FECF was performed in 143 cases and MECF was performed in 81 cases. Results: Average MEP amplitude significantly increased from 292 mV before to 677 mV after nerve root decompression in patients who underwent the FECF. The average improvement rate was 273%. In patients who underwent the MECF, average MEP amplitude significantly increased from 306 mV before to 432 mV after nerve root decompression. The average improvement rate was 130%. The improvement rate was significantly higher for FECF compared with MECF. Conclusions: MEP amplitude increased after nerve root decompression in both FECF and MECF, but the improvement rate was higher in FECF. These results suggest that FECF might be more minimally invasive than MECF in terms of neurological aspects.
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spelling pubmed-76980792020-11-29 A Comparative Study on the Minimal Invasiveness of Full-Endoscopic and Microendoscopic Cervical Foraminotomy Using Intraoperative Motor Evoked Potential Monitoring Hirahata, Masahiro Kitagawa, Tomoaki Fujita, Muneyoshi Shiboi, Ryutaro Kawano, Hirotaka Iwai, Hiroki Inanami, Hirohiko Koga, Hisashi Medicina (Kaunas) Article Background and Objectives: Full-endoscopic cervical foraminotomy (FECF) and microendoscopic cervical foraminotomy (MECF) are effective surgeries for cervical radiculopathy and are considered minimally invasive in terms of damage to paraspinal soft tissue. However, no studies have quantitatively compared FECF and MECF in terms of neurological invasiveness. The aim of this study was to compare the neurological invasiveness of FECF and MECF using intraoperative motor evoked potential (MEP) monitoring. Materials and Methods: A chart review was conducted of 224 patients with cervical radiculopathy who underwent FECF or MECF between April 2014 and March 2020. Patients were 37 women and 187 men, with a mean age of 51 (range, 21–86) years. FECF was performed in 143 cases and MECF was performed in 81 cases. Results: Average MEP amplitude significantly increased from 292 mV before to 677 mV after nerve root decompression in patients who underwent the FECF. The average improvement rate was 273%. In patients who underwent the MECF, average MEP amplitude significantly increased from 306 mV before to 432 mV after nerve root decompression. The average improvement rate was 130%. The improvement rate was significantly higher for FECF compared with MECF. Conclusions: MEP amplitude increased after nerve root decompression in both FECF and MECF, but the improvement rate was higher in FECF. These results suggest that FECF might be more minimally invasive than MECF in terms of neurological aspects. MDPI 2020-11-11 /pmc/articles/PMC7698079/ /pubmed/33187319 http://dx.doi.org/10.3390/medicina56110605 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hirahata, Masahiro
Kitagawa, Tomoaki
Fujita, Muneyoshi
Shiboi, Ryutaro
Kawano, Hirotaka
Iwai, Hiroki
Inanami, Hirohiko
Koga, Hisashi
A Comparative Study on the Minimal Invasiveness of Full-Endoscopic and Microendoscopic Cervical Foraminotomy Using Intraoperative Motor Evoked Potential Monitoring
title A Comparative Study on the Minimal Invasiveness of Full-Endoscopic and Microendoscopic Cervical Foraminotomy Using Intraoperative Motor Evoked Potential Monitoring
title_full A Comparative Study on the Minimal Invasiveness of Full-Endoscopic and Microendoscopic Cervical Foraminotomy Using Intraoperative Motor Evoked Potential Monitoring
title_fullStr A Comparative Study on the Minimal Invasiveness of Full-Endoscopic and Microendoscopic Cervical Foraminotomy Using Intraoperative Motor Evoked Potential Monitoring
title_full_unstemmed A Comparative Study on the Minimal Invasiveness of Full-Endoscopic and Microendoscopic Cervical Foraminotomy Using Intraoperative Motor Evoked Potential Monitoring
title_short A Comparative Study on the Minimal Invasiveness of Full-Endoscopic and Microendoscopic Cervical Foraminotomy Using Intraoperative Motor Evoked Potential Monitoring
title_sort comparative study on the minimal invasiveness of full-endoscopic and microendoscopic cervical foraminotomy using intraoperative motor evoked potential monitoring
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7698079/
https://www.ncbi.nlm.nih.gov/pubmed/33187319
http://dx.doi.org/10.3390/medicina56110605
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