Anterior Percutaneous Full-Endoscopic Transcorporeal with Single-Incision Treatment for Noncontiguous 2-Level Cervical Disc Herniation: Technical Report and Early Follow-Up

World Neurosurg. 2024 May:185:115-125. doi: 10.1016/j.wneu.2023.11.083. Epub 2024 Jan 17.

Abstract

Background: Noncontiguous 2-level cervical disc herniation (NCT-CDH) is a common condition that often requires surgical intervention. In this study, we developed a surgical approach for the treatment of NCT-CDH using anterior percutaneous full-endoscopic single incision through the vertebral body. We provide a brief overview of its safety, efficacy, and feasibility, along with a description of our relevant surgical experience.

Methods: A retrospective study was conducted, involving 30 patients who were followed up for at least 12 months. Preoperative and postoperative visual analog scale, Japanese Orthopedic Association scores, Nurick scores, intervertebral disc height, and modified Macnab criteria were recorded. Patients underwent regular radiological evaluations throughout the follow-up period.

Results: Postoperative computed tomography, magnetic resonance imaging, and X-ray examinations revealed bone tunnel healing, intact drilled vertebral bodies without collapse, adequate decompression of the spinal canal, and normal cervical mobility. There was a significant improvement in postoperative visual analog scale, Japanese Orthopedic Association scores, Nurick scores, and modified Macnab criteria compared to the preoperative values (P < 0.05).

Conclusions: Our study revealed that the anterior percutaneous full-endoscopic transcorporeal with single-incision treatment for NCT-CDH is a safe and feasible surgical method. Therefore, it can be considered as a viable treatment option for patients with NCT-CDH.

Keywords: Cervical disc excision; Minimally invasive surgery; Noncontiguous 2-level cervical disc herniation; Percutaneous full-endoscopic; Transcorporeal approach.

MeSH terms

  • Adult
  • Aged
  • Cervical Vertebrae* / diagnostic imaging
  • Cervical Vertebrae* / surgery
  • Diskectomy, Percutaneous / methods
  • Endoscopy / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Intervertebral Disc Displacement* / diagnostic imaging
  • Intervertebral Disc Displacement* / surgery
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome