Management of a Rare Case of C2–3 Cervical Foraminal Disc Herniation by Unilateral Biportal Endoscopic Foraminotomy

Abstract

Foraminal disc herniation at the C2–3 level is a very rare entity, for which a consensus treatment protocol has not been established. This case report explains that unilateral biportal endoscopic foraminotomy is a very effective, minimally invasive, and safe procedure for this condition. A 62-year-old woman presented to our clinic with complaints of a 6-week history of posterior axial neck pain and sudden onset of hypoesthesia over the right periauricular region, face and lip. Magnetic resonance imaging (MRI) revealed C2–3 right foraminal disc herniation, and posterior cervical foraminotomy was done using the unilateral biportal endoscopic technique. The patient reported complete relief of the axial neck pain soon after surgery and gradual improvement of the hypoesthesia. Postoperative MRI showed complete removal of the compressing disc fragment. In conclusion, this case shows that a minimally invasive biportal endoscopic procedure can be a better choice for decompression than many extensive and destructive procedures. This is the first case report in the literature describing the management of C2–3 foraminal disc herniation by posterior cervical unilateral biportal endoscopic foraminotomy.