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Full-endoscopic posterior foraminotomy surgery for cervical disc herniations

Vollendoskopische dorsale Foraminotomie zur Operation des zervikalen Bandscheibenvorfalls

  • Surgical Techniques
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Operative Orthopädie und Traumatologie Aims and scope Submit manuscript

Abstract

Objective

Surgery for cervical disc herniation with full-endoscopic posterior access.

Indications

Cervical disc herniation and neuroforaminal pathology with radicular symptoms.

Contraindications

Neck pain alone, cervical myelopathy or pathologies with central nervous system symptoms, instabilities requiring correction/instabilities.

Surgical technique

Introduction of a surgical tube to the facet joint at the level to be operated on. Resection of bony and ligamentous parts of the cervical spinal canal under endoscopic guidance. Visualisation of the disc herniation and decompression of the neural structures.

Postoperative management

Immediate mobilisation, specific rehabilitative physiotherapy depending on pre-existing neurological deficits.

Results

A total of 87 patients underwent full-endoscopic posterior surgery and were followed over a period of 2 years. Significant improvement was observed. No serious complications occurred. In all, 5 patients underwent revision in the follow-up period. Of the patients, 93% would undergo the procedure again.

Zusammenfassung

Operationsziel

Operation zervikaler Bandscheibenvorfälle mit einem dorsalen vollendoskopischen Zugang.

Indikationen

Zervikale Bandscheibenvorfälle und Pathologien im Neuroforamen mit radikulärer Symptomatik.

Kontraindikationen

Reiner Nackenschmerz, zervikale Myelopathie oder Pathologien mit zentralnervöser Symptomatik, korrekturbedürftige Instabilitäten/Instabilitäten.

Operationstechnik

Einbringen einer Operationshülse auf das Facettengelenk der zu operierenden Etage. Unter endoskopischer Sicht Resektion von knöchernen und ligamentären Anteilen des zervikalen Spinalkanals. Darstellen des Bandscheibenvorfalls und Dekompression der neuralen Strukturen.

Weiterbehandlung

Sofortige Mobilisation, weiche Halsorthese bis zur Wundheilung, spezifische rehabilitative physiotherapeutische Maßnahmen in Abhängigkeit von vorbestehenden neurologischen Defiziten.

Ergebnisse

Insgesamt wurden 87 Patienten vollendoskopisch dorsal operiert und über 2 Jahre nachuntersucht. Dabei zeigte sich eine signifikante Verbesserung. Schwere Komplikationen traten nicht auf. Im Nachbeobachtungszeitraum wurden 5 Patienten revidiert. Den Eingriff würden 93 % der Patienten erneut durchführen lassen.

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Authors

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Correspondence to M. Komp.

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Conflict of interest

M. Komp, S. Özdemir, P. Hahn and S. Ruetten declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

Editor

M. Mayer, Munich

Illustrator

J. Kühn, Mannheim

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Komp, M., Oezdemir, S., Hahn, P. et al. Full-endoscopic posterior foraminotomy surgery for cervical disc herniations. Oper Orthop Traumatol 30, 13–24 (2018). https://doi.org/10.1007/s00064-017-0529-1

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  • DOI: https://doi.org/10.1007/s00064-017-0529-1

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