{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:51:40Z","timestamp":1786125100214,"version":"build-2736575974"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2018,8,31]],"date-time":"2018-08-31T00:00:00Z","timestamp":1535673600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2019,5]]},"abstract":"Abstract<\/jats:title>\n \n BACKGROUND<\/jats:title>\n The posterior cervical keyhole (KH) laminoforaminotomy has been described to involve the lateral portion of cervical laminae of the upper vertebra alone (small KH) or of both upper and lower vertebrae (large KH).<\/jats:p>\n <\/jats:sec>\n \n OBJECTIVE<\/jats:title>\n To microscopically compare the two keyhole techniques in terms of their ability to expose the corresponding cervical roots.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n Ten cadaveric specimens were operated bilaterally from C3-4 to C6-7 level to expose a total of 80 nerve roots. The large KH was applied to the left side, the small KH to the right side. The maximal length of exposed nerve roots was measured under microscope. The virtual optimal KH surface area was determined using digital software. Each root was inspected for exposure of its root and axilla.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n The maximal exposed nerve root length on the large KH side was significantly larger than on the small KH side at C3-4, C5-6, and C6-7 levels (\n P<\/jats:italic>\n \u00a0=\u00a0.031,\n P<\/jats:italic>\n \u00a0=\u00a0.002,\n P<\/jats:italic>\n \u00a0=\u00a0.003). No significance was reported for C4-5 (\n P<\/jats:italic>\n \u00a0=\u00a0.06). We could expose right axillae in (3\/40) and left axillae in (33\/40;\n P<\/jats:italic>\n \u00a0<\u00a0.001). Optimal keyhole surface areas were 37.9, 38.2, 38.7, and 46.2 mm\n 2<\/jats:sup>\n in craniocaudal order.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n Large KH defects involving both upper and lower laminae and facets can expose the roots to greater extent than small KH defects at C3-4, C5-6, and C6-7 levels. Large KH defects may allow better exposure of nerve roots axillae than small KH defects.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/ons\/opy230","type":"journal-article","created":{"date-parts":[[2018,8,30]],"date-time":"2018-08-30T22:14:26Z","timestamp":1535667266000},"page":"607-613","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Posterior Cervical Keyhole Laminoforaminotomy: A Cadaveric Comparative Study to Evaluate Limits of Bony Resection"],"prefix":"10.1227","volume":"16","author":[{"given":"Ahmed B","family":"Bayoumi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Medical Park Goztepe Hospital, Bahcesehir University School of Medicine, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selim","family":"Berk","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical Park Goztepe Hospital, Bahcesehir University School of Medicine, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim E","family":"Efe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical Park Goztepe Hospital, Bahcesehir University School of Medicine, Istanbul, Turkey"},{"name":"Department of Neurosurgery, Charite Universit\u00e4tsmedizin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elif Gulsah","family":"Bas","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical Park Goztepe Hospital, Bahcesehir University School of Medicine, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Duran","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical Park Goztepe Hospital, Bahcesehir University School of Medicine, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tolga","family":"Yigit","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical Park Goztepe Hospital, Bahcesehir University School of Medicine, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agin","family":"Erden","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical Park Goztepe Hospital, Bahcesehir University School of Medicine, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce S","family":"Kristal","sequence":"additional","affiliation":[{"name":"Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts"},{"name":"Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Turker","family":"Kilic","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical Park Goztepe Hospital, Bahcesehir University School of Medicine, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deniz","family":"Konya","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical Park Goztepe Hospital, Bahcesehir University School of Medicine, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zafer Orkun","family":"Toktas","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical Park Goztepe Hospital, Bahcesehir University School of Medicine, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,5]]},"reference":[{"key":"bib1-20240909","first-page":"222","article-title":"The cervical ruptured disc; 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