Total uncinectomy of the cervical spine with an osteotome: technical note and intraoperative video

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Total uncinate process resection or uncinectomy is often required in the setting of severe foraminal stenosis or cervical kyphosis correction. The proximity of the uncus to the vertebral artery, nerve root, and spinal cord makes this a challenging undertaking. Use of a high-speed burr or ultrasonic bone dissector can be associated with direct injury to the vertebral artery and thermal injury to the surrounding structures. The use of an osteotome is a safe and efficient method of uncinectomy. Here the authors describe their technique, which is illustrated with an intraoperative video.

ABBREVIATIONS PLL = posterior longitudinal ligament; UP = uncinate process; VA = vertebral artery.

Article Information

Correspondence Anand H. Segar: NYU Langone Orthopedic Hospital, New York, NY. ahsegar@gmail.com.

INCLUDE WHEN CITING Published online August 23, 2019; DOI: 10.3171/2019.6.SPINE19332.

Disclosures Dr. Protopsaltis is a consultant for Globus, K2M, NuVasive, Medicrea, and Innovasis. Dr. Riccio has direct stock ownership in Revivo Medical.

© AANS, except where prohibited by US copyright law.

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Figures

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    Preoperative (A–C) and postoperative (D–F) CT and MRI scans obtained before and after left-sided uncinectomy at C6 and C7 for left-sided radiculopathy due to severe osteophytic foraminal stenosis. Coronal CT scans (panels A and D) show UPs that underwent resection (orange arrowheads). Axial CT scans (panels B and E) show wide foraminal decompression (red arrowheads). Axial MR images (panels C and F) confirmed wide foraminal decompression (green arrowheads). Figure is available in color online only.

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    CT scans obtained preoperatively (A) and postoperatively (B–D) after bilateral uncinectomy at C6/7 as part of an anterior column release for the treatment of fixed cervical kyphosis. Preoperative image (A) shows bilateral uncal osteophytes. Postoperative coronal (B) and parasagittal (C and D) images show complete bilateral uncinectomy.

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