Servikal Posterior Laminoforaminotomi (Key-Hole) Yöntemi ile Cerrahi Yaklaşımda Vertebral Oluşumların İşaret Noktalarının Anatomik ve Radyolojik Değerlendirilmesi

Abstract

The cervical portion of the vertebral column, due to its delicate structure, is vulnerable to pathologies such as cervical disc herniations attributed to its high mobility and biomechanical loading. While anterior cervical microdiscectomy is primarily preferred for surgical indications such as disc herniations and foraminal stenosis, the posterior cervical laminoforaminotomy (key-hole) method can also be utilized in cases involving lateralized soft disc herniations and foraminal stenosis. The significance of the posterior cervical laminoforaminotomy method is believed to stem from its lower likelihood of postoperative morbidity and instability associated with anteriorly located vital structures. The aim of this study is to perform morphometric measurements of the cervical vertebral anatomy using computerized tomography and magnetic resonance imaging methods, supplementing these measurements with those obtained from cadaveric specimens through surgical anatomical dissections, conducting detailed statistical analyses to establish the relationship between these values, and reaching a synthesis. Morphometric measurements were conducted on laminae, facet joints, and superior and inferior articular processes of C2-C7 in 50 cases through radiological imaging methods and in 8 fresh-frozen cadavers through surgical anatomical dissections. All measurements were statistically analyzed, compared, and interpreted. In studies aiming to assess the concordance between measurements obtained through computed tomography (CT) and magnetic resonance imaging (MRI) techniques, while congruence has been observed across numerous parameters, CT currently demonstrates superiority over MRI in the precise anatomical evaluation and surgical planning of the region, given the present technological status of CT compared to MRI. Ultimately, it is anticipated that this study will assist relevant neurosurgeons, benefit anatomy education programs, and anatomists in the field.