Naoto Tsuchiya, M.D.
Neurosurgeon
Shinagawa Shisyokai Hospital
Kitashinagawa 1-29-7
Shinagawa Tokyo Japan
140-0001
Tel:81-3-5781-0700
Fax:81-3-5781-0828
What is Microsurgical Anterior Cervical Foraminotomy (MacF)？
The cervical spine contains the spinal cord, and 8 pairs of cervical nerve roots which control the movement and sensation of both arms and hands. Symptoms, such as pain, numbness, and tingling of shoulders, arms, and hands, are induced by compression of misplaced cartilage (disc herniation), and bone spurs on nerve roots. To remove compression (decompression) on nerve roots, surgeons excise cartilage and bone spurs from the front of the cervical spine under a microscope to improve blood circulation, and repair damaged function of the nerve root to improve symptoms.
What is the surgical procedure?
A transverse cut approximately 25-35 mm in length is made in the front of the neck along the skin fold. Neck muscles are retracted through the skin incision, and the front part of the cervical spine is examined to identify the lateral corner of disc space (Luschka joint). The area of the Luschka joint is excised by electric drill to expose the nerve root for decompression under the microscope (Key hole surgery). Misplaced cartilage, bone spurs, and ossified ligaments which compress the nerve root are thoroughly excised. Metallic implants are not used for stabilization. A drain tube is left in the wound and the skin is closed using DERMABOND®. A cervical brace is not applied.
The operating time is approximately one to two hours. Introduction of anesthesia and post-anesthesia arousal time take approximately one additional hour, making the total operation time two to three hours.
What is the effect of surgery?
Immediately after surgery, symptoms improve due to increased blood circulation to nerve roots. In some patients, edema or inflammation of the nerve root may occur as a result of acute decompression, and symptoms may stop improving between two days to one month after surgery. However, symptoms due to edema and inflammation subside in three to four months. Symptoms become permanent in less than 1% of patients. Improvement is much stronger in cases of nerve root damage than in spinal cord damage, and maximum symptom improvement occurs at six months post-surgery. Some patients, such as those who have long standing symptoms or severely damaged nerves, may not recover completely, leaving numbness, tingling, and weakness in the hands and arms. Long term significant weakness in the arms and hands may take one year or more to recover. In some patients, decompressed and enlarged nerve root canals may narrow or close after surgery. Approximately 1% of patients require a second operation.
For those undergoing Microsurgical Anterior Cervical Foraminotomy (MacF) open subtitle | |
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| Science & Technology | Upload TimePublished on 30 Jan 2018 |
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