A New Full-Endoscopic Technique for Cervical Posterior Foraminotomy in the Treatment of Lateral Disc Herniations Using 6.9-mm Endoscopes: Prospective 2-Year Results of 87 Patients

Abstract

Anterior cervical decompression and fusion (ACDF) is the standard procedure for operation of cervical disc herniations with radicular arm pain. Mobility-preserving posterior foraminotomy is the most common alternative in the case of a lateral localization of the pathology. Despite good clinical results, problems may arise due to traumatization of the access. Endoscopic techniques are considered standard in many areas, since they may offer advantages in surgical technique and rehabilitation. These days, all disc herniations of the lumbar spine can be operated in a full-endoscopic technique. The objective of this prospective study was to examine the technical possibilities of full-endoscopic posterior foraminotomy in the treatment of cervical lateral disc herniations. 87 patients were followed for 2 years. The results show that 87.4% no longer have arm pain and 9.2% have only occasional pain. The decompression results were equal to those of conventional procedures. The operation-related traumatization was reduced. The recurrence rate was 3.4%. No serious surgical complications occurred. The recorded results show that the full-endoscopic posterior foraminotomy is a sufficient and safe supplement and alternative to conventional procedures when the indication criteria are fulfilled. At the same time, it offers the advantages of a minimally invasive intervention.

Full-Endoscopic Interlaminar Versus Microsurgical Operations in Lumbar Compressive Lesions Surgery: Prospective Randomized Trial of Overall 570 Patients

“…Also the route of access in the innervation area of the dorsal branch of the spinal nerves can have a negative influence on the stabilizing and coordination system [62,63]. For this reason, attempts are made even in the primary operation, and also in revisions, to work with tissue-sparing techniques [64,65] Furthermore, technical advances have been made in the primary operation of disc herniations which enable a full-endoscopic technique and provides the advantages of a truly minimally invasive procedure [64,[66][67][68].…”

Full-endoscopic cervical arcocristectomy for the treatment of spinal stenosis: results of a cadaver study

“…Nonetheless, the disadvantage of extended surgical approach remains. To avoid the invasiveness of the above-mentioned approach different tubular or complete endoscopic procedures to the cervical spine have been introduced [3,12,15,19]. Cervical disc disease is the leading indication for endoscopic foraminotomy according to literature.…”

Outcomes of full-endoscopic posterior cervical foraminotomy for cervical radiculopathy caused by bony stenosis of the intervertebral foramen

“…The use of full-endoscopic posterior cervical foraminotomy (FPCF) to treat lateral disc herniation was first reported by Ruetten et al [17,18] in 2007. They concluded that FPCF is a sufficient and safe supplement and alternative to conventional procedures.…”

“…FPCF was performed according to the method of Ruetten et al [17] The patient was placed in the prone position under general anesthesia. In patients with pathology on the left side of C5/6, a skin incision was made under fluoroscopy at the intersection of a line at the C5/6 disc level [ Figure 2A] and a line at the medial edge of the facet joint on the left side [ Figure 2B].…”