- Posterior Cervical discectomy:
- Standing height Keep level of pt at the surgeon’s iliac crest
- use the RF bipolar as a feather touch. Just touch the tip.
- The cannula is placed with the tip on the lateral mass and the lip facing the medially.
- Needle marking
- AP view: Mid point of facet
- Lateral view: on the pedicle:
- Keep trajectory in the direction of the disc and verticle in the Cranial caudal angle
- knife to carefully cut the skin and muscle with II guidance
- as the muscle is thicker in cervical hard to angle
- Find and stay within the V point
- The point where the inferior border of the upper lamina, the superior edge of the lower lamina, and the medial point of the facet joint converge
- Drill with a fluted/oval burr with a protector
- can see the tip all the time → safer
- drill the borders of the V point
- as you go from cranial to caudal: the more of the inferior laiman you need to take is greater and the superior lamina you need to take is lesser
- use a dissector to blunt dissect between the flavum and the bone
- the flavum thins out lateral and inferiorly
- use a kerrison to detach the flavum completely away from the V point borders
- Go in the axillae (Caudal) and shoulder (cranial) of the nerve root
- Becareful the vertebral artery is deep and lateral
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