{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T18:52:10Z","timestamp":1770490330344,"version":"3.49.0"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,4,13]],"date-time":"2020-04-13T00:00:00Z","timestamp":1586736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Anatomy"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Cervical radiculopathy from uncovertebral joint (UVJ) hypertrophy and nerve root compression often occurs anterior and lateral within the cervical intervertebral foramen, presenting a challenge for complete decompression through anterior cervical approaches owing to the intimate association with the vertebral artery and associated venous plexus. Complete uncinatectomy during anterior cervical discectomy and fusion (ACDF) is a controversial topic, many surgeons relying on indirect nerve root decompression from restoration of disc space height. However, in cases of severe UVJ hypertrophy, indirect decompression does not adequately address the underlying pathophysiology of anterolateral foraminal stenosis. Previous reports in the literature have described techniques involving extensive dissection of the cervical transverse process and lateral uncinate process (UP) in order to identify the vertebral artery for safe removal of the UP. Recent anatomical investigations have detailed the microanatomical organization of the fibroligamentous complex surrounding the UP and neurovascular structures. The use of the natural planes formed from the encapsulation of these connective tissue layers provides a safe passage for lateral UP dissection during anterior cervical approaches. This can be performed from within the disc space during ACDF to avoid extensive lateral dissection. In this article, we present our 10\u2010year experience using an anatomy\u2010based microsurgical technique for safe and complete removal of the UP during ACDF for cervical radiculopathy caused by UVJ hypertrophy.<\/jats:p>","DOI":"10.1002\/ca.23596","type":"journal-article","created":{"date-parts":[[2020,4,2]],"date-time":"2020-04-02T09:03:55Z","timestamp":1585818235000},"page":"920-926","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Microanatomical considerations for safe uncinate removal during anterior cervical discectomy and fusion: 10\u2010year experience"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3533-8776","authenticated-orcid":false,"given":"William","family":"Clifton","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery Mayo Clinic Florida  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fidel","family":"Valero\u2010Moreno","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery Mayo Clinic Florida  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Vlasak","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery Mayo Clinic Florida  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron","family":"Damon","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery Mayo Clinic Florida  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1317-1047","authenticated-orcid":false,"given":"R. Shane","family":"Tubbs","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Structural and Cellular Biology Tulane University School of Medicine  New Orleans Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Merrill","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine  Scottsdale Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Pichelmann","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Mayo Clinic Health Systems  Eau Claire Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,4,13]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-3019(97)00315-7"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/pme.12121"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31819b2b5d"},{"key":"e_1_2_6_5_1","first-page":"1","article-title":"Letter to the editor. Safety in the use of a high\u2010speed burr for total uncinectomy during acdf","volume":"32","author":"Clifton W.","year":"2019","journal-title":"Journal of Neurosurgery Spine"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-019-04033-w"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199706000-00028"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01653127"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/pme.12266"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.22317"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-016-9349-4"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1996.84.2.0155"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12565-010-0080-8"},{"key":"e_1_2_6_14_1","volume-title":"Statpearls","author":"Magnus W.","year":"2020"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.3171\/2014.10.JNS14906"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-199610000-00026"},{"issue":"4","key":"e_1_2_6_17_1","first-page":"535","article-title":"Ultrasonic total uncinectomy: A novel technique for complete anterior decompression of cervical nerve roots","volume":"10","author":"Pakzaban P.","year":"2014","journal-title":"Neurosurgery"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-005-0040-5"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.14245\/ns.1836272.136"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.3171\/2019.6.SPINE19332"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/ons\/opy071"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.3171\/2011.12.SPINE11541"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.3171\/spi.2000.93.2.0248"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199511000-00001"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-002-0087-5"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.10158"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmr.2011.02.013"}],"container-title":["Clinical Anatomy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fca.23596","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ca.23596","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ca.23596","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ca.23596","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T12:39:32Z","timestamp":1737117572000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ca.23596"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,13]]},"references-count":26,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,9]]}},"alternative-id":["10.1002\/ca.23596"],"URL":"https:\/\/doi.org\/10.1002\/ca.23596","archive":["Portico"],"relation":{},"ISSN":["0897-3806","1098-2353"],"issn-type":[{"value":"0897-3806","type":"print"},{"value":"1098-2353","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,13]]},"assertion":[{"value":"2020-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}