Minimally invasive fully endoscopic two-level posterior cervical foraminotomy: technical note

Abstract

Posterior cervical foraminotomy is an effective surgical treatment method for relieving radicular symptoms that result from cervical nerve root compression. Minimally invasive techniques and tubular retractor systems are available to minimize tissue retraction, but minimally invasive approaches can carry with them the surgical challenge of trying to pass instruments through a long narrow retractor that is also the port for visualizing the surgical pathology. Herein, the authors present a case of a 65-year-old man who presented with symptoms of a left C6 and C7 radiculopathy and left C5-6 and left C6-7 foraminal narrowing on MRI. A minimally-invasive fully endoscopic left C5-6 and C6-7 posterior foraminotomy was performed through a 1cm outer diameter working channel endoscopic with a 6 mm working channel. Clinicians should be aware that new minimally invasive non-fusion approaches for the treatment of cervical radiculopathy that utilize endoscopic visualization are now coming into use in clinical practice.

Comparative Evaluation of Posterior Percutaneous Endoscopic Cervical Discectomy Using 3.7mm Endoscopic and 6.9mm Endoscopic for Cervical Disc Herniation: a retrospective comparative cohort study.

“…The herniated cervical disc was removed through the shoulder or axilla of the exiting nerve root according to the lesion location ( Figure 3). It is critical to palpate the exiting nerve root using a nerve hook and should feel free after intervertebral disc adequately removed (30,31). Figures 4-6 show the case of a 60-year-old male with cervical discomfort with radiation pain of right shoulder and upper extremity.…”

Comparative Evaluation of Posterior Percutaneous Endoscopic Cervical Discectomy Using 3.7mm Endoscopic and 6.9mm Endoscopic for Cervical Disc Herniation: a retrospective comparative cohort study. 

“…The herniated cervical disc was removed through the shoulder or axilla of the exiting nerve root according to the lesion location ( Figure 2). It is critical to palpate the exiting nerve root using a nerve hook and should feel free after intervertebral disc adequately removed (30,31). Figure 3 show the case of a 60-year-old male with cervical discomfort with radiation pain of right shoulder and upper extremity.…”

Percutaneous endoscopic cervical discectomy: a technical review

“…It is also possible to observe the medial margin of the spinal cord for an adequate orientation and decompression of exiting nerve root. After a successful discectomy, the exiting nerve root should feel free when it is palpated with a nerve hook (14,35,36). Figure 8 shows the case of a 24-year-old male with severe neck and left shoulder pain.…”

“…In the other techniques, each hand is used for the surgical instruments (suction and working tools) (35,36).…”