Posterior Cervical Decompression and Fusion With Exoscope: 2-Dimensional Operative Video.

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2022-02

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Abstract

Posterior cervical decompression and fusion is an effective strategy for correction of cervical spondylotic myelopathy. Here, we highlight the operative treatment of a 63-yr-old man entailing a 4-level posterior cervical laminectomy and fusion, with the use of an exoscope throughout. The patient initially presented with symptoms of gait dysfunction and loss of fine motor control in the upper extremities, without neck pain or radiculopathy. His imaging demonstrated a congenitally narrowed spinal canal with cervical stenosis at C3-C4, C5-C6, and C6-C7. The patient consented to the procedure and publication of his image, along with other participants and any identifiable individuals. The operation proceeded with the patient in a prone position with midline dissection to the posterior elements of C3-C6. Pilot holes were drilled in the lateral masses and C3-C4, C4-C5, C5-C6, and C6-C7 laminectomies performed using a high-speed drill, with removal of the laminae en bloc. Lateral mass screws were inserted and precontoured rods secured, with morselized autograft and allograft bone chips placed for arthrodesis. Postoperatively, the patient reported noted improvement in his symptoms.

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10.1227/ons.0000000000000058

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Srinivasan, Ethan S, Clifford L Crutcher, Christopher I Shaffrey, Oren N Gottfried and Khoi D Than (2022). Posterior Cervical Decompression and Fusion With Exoscope: 2-Dimensional Operative Video. Operative neurosurgery (Hagerstown, Md.), 22(2). p. e83. 10.1227/ons.0000000000000058 Retrieved from https://hdl.handle.net/10161/28045.

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Crutcher

Clifford Crutcher

Assistant Professor of Neurosurgery

I am a neurosurgeon who specializes in spine surgery. I take care of people with conditions affecting the cervical, thoracic, and lumbar spine, including herniated disc, spinal stenosis, spondylolisthesis, and adult degenerative scoliosis. I also provide general neurosurgery care. I really enjoy developing a relationship with my patients and their family. I try to tailor my approach and treatment plans to each patient based on their unique goals and needs. Often, nonsurgical options are available to improve the patient’s symptoms. My goal is to help people return to their previous level of functioning and to help people enjoy life again. Outside of work, I love spending time with my wife and two children. I also enjoy fishing and running on trails.

Gottfried

Oren N Gottfried

Professor of Neurosurgery

I specialize in the surgical management of all complex cervical, thoracic, lumbar, or sacral spinal diseases by using minimally invasive as well as standard approaches for arthritis or degenerative disease, deformity, tumors, and trauma. I have a special interest in the treatment of thoracolumbar deformities, occipital-cervical problems, and in helping patients with complex spinal issues from previously unsuccessful surgery or recurrent disease.I listen to my patients to understand their symptoms and experiences so I can provide them with the information and education they need to manage their disease. I make sure my patients understand their treatment options, and what will work best for their individual condition. I treat all my patients with care and concern – just as I would treat my family. I am available to address my patients' concerns before and after surgery.  I aim to improve surgical outcomes for my patients and care of all spine patients with active research evaluating clinical and radiological results after spine surgery with multiple prospective databases. I am particularly interested in prevention of spinal deformity, infections, complications, and recurrent spinal disease. Also, I study whether patient specific variables including pelvic/sacral anatomy and sagittal spinal balance predict complications from spine surgery.


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