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.
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.
Ruetten
S
S
Department of Spine Surgery and Pain Therapy, Center for Orthopaedics and Traumatology, St. Anna-Hospital Herne, at the Department of Radiology and Microtherapy, University of Witten/Herdecke, Herne, Germany. info@s-ruetten.com
Komp
M
M
Merk
H
H
Godolias
G
G
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000033:anatomy & histology / Q000473:pathology / Q000601:surgery*; D019299:Decompression, Surgical / Q000295:instrumentation* / Q000379:methods; D017587:Diskectomy, Percutaneous / Q000295:instrumentation / Q000379:methods; D019723:Endoscopes / Q000592:standards*; D004724:Endoscopy / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000033:anatomy & histology / Q000473:pathology / Q000601:surgery; D007405:Intervertebral Disc Displacement / Q000473:pathology / Q000601:surgery*; D007796:Laminectomy / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D019547:Neck Pain / Q000209:etiology / Q000473:pathology / Q000601:surgery; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D011843:Radiculopathy / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D012008:Recurrence; D013126:Spinal Nerve Roots / Q000033:anatomy & histology / Q000293:injuries / Q000601:surgery; D013128:Spinal Osteophytosis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome