The objective was to investigate the effective and safe range of paramedian CDH by percutaneous posterior full-endoscopy cervical intervertebral disc nucleus pulposus resection (PPFECD) to provide a reference for indications and patient selection. Sixteen patients with CDH satisfied the inclusion criteria. Before surgery the patients underwent cervical spine MRI, and the distance between the dural sac and herniated disc was measured. An assessment was performed by MRI immediately after surgery, measuring the distance between dural sac and medial border of discectomy (DSMD). The preoperative average distance between the dural sac and peak of the herniated disc (DSPHD) was 3.87 ± 1.32 mm; preoperative average distance between dural sac and medial border of herniated disc (DSMHD) was 6.91 ± 1.21 mm and an average distance of postoperative DSMD was 5.41 ± 1.40 mm. Postoperative VAS of neck and shoulder pain was significantly decreased but JOA was significantly increased in each time point compared with preoperative ones. In summary, the effective range of PPFECD to treat paramedian CDH was 5.41 ± 1.40 mm, indicating that DSMHD and DSPHD were within 6.91 ± 1.21 mm and 3.87 ± 1.32 mm, respectively. PPFECD surgery is, therefore, a safe and effective treatment option for patients with partial paramedian cervical disc herniation.

The objective of this study is to introduce a method using a percutaneous full-endoscopic interlaminar approach via a surrounding nerve root discectomy (SNRD) operative route that involves removing the protrusive disc via both the shoulder and the axilla of the corresponding nerve root for the treatment of ventral-type lumbar disc herniation (VLDH) and its early clinical symptoms. Twenty-two patients with VLDH satisfied the inclusion criteria and underwent the full-endoscopic interlaminar approach operation via a SNRD successfully during the period from November 2014 to June 2016. All operations were completed without conversion to other surgical techniques. The average operation time was 78.64 ± 25.97 min (50–145 min). The average removed disc tissue volume was 2.87 ± 0.48 ml (2–3.6 ml). No nerve root injury, infection, or other complications occurred. The postoperative ODI and VAS values of low back and sciatic pain were significantly decreased at each time point compared to preoperative measurements (P < 0.05). The MacNab scores at the 12-month follow-up included 15 excellent and 7 good scores. In summary, a percutaneous full-endoscopic interlaminar approach through SNRD is a safe and effective treatment option for patients with VLDH.

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