Patients with especially cervical lateral soft disc herniation profit a lot from a posterior microdiscectomy. When patient selection is good, the results are comparable to ACDF as well as the reoperation rate at the index level. Other advantages are missing of adverse events of the ventral access and an absent necessity for a device. But adjacent segment operation rate seems also to be comparable to ACDF so that the motion-preserving effect of posterior microdiscectomy might not prevent adjacent segment degeneration.
There are two ways for operation especially concerning the approach: classic midline or transmuscular. The transmuscular approach has less morbidity but is more difficult to learn.
In the literature, there are not many RCTs concerning posterior microdiscectomy so the level of evidence is not high.
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