DOI: 10.4103/neurol-india.neurol-india-d-26-00656 ISSN: 0028-3886
Juxta-Midline Subperiosteal Approach – A Modified Unilateral Biportal Endoscopic Posterior Cervical Foraminotomy: A Technical Note
Shyam Sundar Krishnan, Veena Venkataraman, Kesavan Gurusamy, Kalaiselvi KaruppasamyAbstract:
Background:
Posterior biportal endoscopic cervical foraminotomy requires para median muscle splitting due to the absence of the lumbar “Son’s fat space” in the cervical spine.
Technical Note:
We propose a modified juxta-midline approach to create a subperiosteal corridor using incisions placed next to the spinous process and subperiosteal muscle stripping to create a continuous working space while avoiding muscle splitting or cutting.
Results and Conclusions:
This modification reduces docking hemorrhage, optimizes fluid flow space, and simplifies fluoroscopy.