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Case Reports: Novel treatment (new drug/interventions; established drug/procedure in new situation)
Minimally invasive fenestration for decompression of C2-C3 spinal stenosis
  1. Patrycja Weronika Hebda1,2 and
  2. Olaf Majewski2
  1. 1Neurosurgery, Queen Elizabeth University Hospital, Glasgow, UK
  2. 2Neurosurgery, Szpital Specjalistyczny im Edmunda Biernackiego w Mielcu, Mielec, Poland
  1. Correspondence to Dr Patrycja Weronika Hebda; patih3{at}yahoo.com

Abstract

Conventional techniques in neurosurgery such as laminectomy have been extensively displaced by minimally invasive types, owing to the character of complexity of cervical spinal region. Spinal canal stenosis at C2-C3 level is documented in the literature with the majority being caused by intervertebral disc herniations.

This case reports a patient who presented with classical myelopathy symptoms and significant thickening of ligamentum flavum, while minimal spondylosis was detected at C2-C3 level. The decompression was performed from posterior approach and limited to the removal of ligamentum flavum with minimal resection of adjacent laminae, no fixation and no disc evacuation. After surgery, there was a significant improvement with preserved spinal stability.

Although the anterior approach is more common for cervical spine, universal access site has not been defined in literature. We suggest that minimal decompression produces desirable effects with no need for fusion and preserving adequate stability of spinal complex.

  • Neurosurgery
  • Head and neck surgery
  • Orthopaedic and trauma surgery
  • Spinal cord

https://doi.org/10.1136/bcr-2022-254174

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    Footnotes

    • Contributors PWH and OM were directly involved in the patient’s care, were responsible for drafting of the text, sourcing and editing of clinical images, investigation of the results and critical revision for important intellectual content and gave final approval of the manuscript. OM is the clinician in charge of the clinical care of the patient, who supervised the preparation of the manuscript, was responsible for obtaining informed consent from the patient and is responsible for the overall integrity of the content of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.