The cumulative reoperation rate after 5 years was 13.4% and half of the reoperations occurred during the first postoperative year. With the exception of laminectomy, the reoperation rates of the other procedures were not different from that of open discectomy.

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PEID may be applied comfortably even for less-experienced surgeons because of the familiar anatomy with open surgery.

For patients with foraminal soft-disk herniation, either MTPF or P-PECD, may be regarded as an alternative options to open surgery. Preoperative kyphotic SA (cut-off value 1.45°) seemed to be associated with poor outcome and this may be considered in selecting surgical methods.

Study Design Case series. Objective Posterior percutaneous endoscopic cervical diskectomy (PECD) can preserve the disk in patients with a foraminal disk herniation. However, progressive angulation at the operated segment is a concern, especially for patients with cervical lordosis < 10 degrees. The change in cervical lordosis after posterior PECD was analyzed. Methods Medical records were reviewed of 32 consecutive patients (22 men, 10 women; mean age, 49 ± 12 years) who had single-level foraminal soft disk herniation. The operation levels were as follows: C4–5 in 1 patient, C5–6 in 12, C6–7 in 18, and C7–T1 in 1. All patients were discharged the day after the operation, and neck motion was encouraged. All patients were followed for 30 ± 7 months (range, 24 to 46 months), and 21/32 patients (66%) had radiographs taken at 25 ± 11 months (range, 12 to 45 months). Radiologic parameters were assessed, including cervical curvature (C2–7), segmental Cobb's angle (SA), and anterior and posterior disk height (AH and PH, respectively) at the operative level. Results At the last follow-up, 29/32 patients (91%) had no or minimal pain, and 3/32 patients had occasional pain. SA, AH, and PH were not significantly changed. Cervical lordosis < 10 degrees was present in 10/21 patients preoperatively and in 3/21 patients at the last follow-up. For patients with cervical lordosis < 10 degrees, cervical curvature changed from −2.5 ± 8.0 to −11.3 ± 9.3 degrees (p = 0.01). For patients with cervical lordosis ≥ 10 degrees, cervical curvature changed from −17.5 ± 5.8 to −19.9 ± 5.7 degrees (p = 0.24). Conclusions Cervical curvature does not worsen after posterior PECD.

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Large ventral IDEM spinal cord tumors can be completely removed using a posterior approach and conventional laminectomy. An understanding of the anatomical and growth characteristics of these tumors is extremely important for successful removal. However, this approach should be applied prudently and with a thorough understanding of its limitations.