Posterior Endoscopic Cervical Foraminotomy

Abstract

Cervical spondylotic radiculopathy (CSR) is a common disease in spinal surgery. Most patients with CSR can be cured after standard conservative treatment, only a small number of patients need surgical treatment when nonsurgical treatment failed. In 1958, Smith and Robinson first performed the anterior cervical discectomy and fusion (ACDF) surgery, and it has been considered as the current gold standard for the treatment of CSR (Smith and Robinson, J Bone Joint Surg (Am), 40(3):607–624, 1958). Although the high intervertebral bone fusion rate and good curative effect have been obtained by this operation, there are still some problems that cannot be ignored, such as pseudarthrosis formation and complications associated with surgical approach. Posterior cervical foraminotomy (PCF) was first described by Spurling and Scoville in 1944 and has proven to be an effective treatment for CSR due to soft disc herniation and can be regarded as an alternative for ACDF (Spurling and Scoville, Surg Gynecol Obstet 78:350–358, 1944). The full decompression of nerve root with the retention of cervical mobility in surgical segments is the main advantage. With the development of minimally invasive spine surgery, Ruetten et al. (Ruetten et al., Minim Invasive Neurosurg 50:219–226, 2007), firstly reported that a novel technology of PCF under percutaneous total spinal endoscopy, which has the advantages of less invasive, less intraoperative blood loss, less postoperative usage of analgesic drugs, and greatly shortened postoperative hospital stay.