He removed not only the bridge of the arcuate forame (Kimmerli , Ponticulus posticus), but also part of the C1 rear arch (that’s a lot). Dr. Lukyanchikov and his student, Ayropetyan (Russia, Moscow), remove only the bridge of the Ponticulus posticus, they do not touch C1. At the same time, this operation is very minimally invasive, the incision is about 3 cm. Dr. Lukyanchikov used to cut a muscle, but Ayropetyan doesn’t even cut a muscle (perhaps Lukyanchikov doesn’t cut a muscle anymore either). This operation is very simple for them and without any complications.Their surgery is not very expensive. Dr. Hayropetyan has about $1,000-$1,400, and Dr. Lukyanchikov’s costs about $1,500-$1,800. Sometimes it happens that this bridge is restored and grows again after 6 months or a year. How is your cervical spine stability? Can you share the CT scans?
@Filya Yes, Dr. Liu’s approach was more extensive than the bridge-only procedure you’re describing, the incision was approximately 8.5 cm. My surgery also included a right C2 dorsal root ganglionectomy, more extensive than just removing the bridge.
I have not noticed any instability at this point after the partial removal of the C1 posterior arch. From what I have read, limited posterior arch removal does not necessarily cause instability, particularly if the stabilizing structures are preserved. If significant pre-existing instability is present, fusion can sometimes be part of the surgical plan.
If it becomes necessary to remove more of C1 because of the remaining right-sided IJV compression, that could have different implications for stability. Hopefully it won’t be necessary.