S Oezdemir1, M Komp2, P Hahn2, S Ruetten2. 1. Zentrum für Wirbelsäulenchirurgie und Schmerztherapie, Zentrum für Orthopädie und Unfallchirurgie, St. Elisabeth Gruppe-Katholische Kliniken Rhein-Ruhr, St. Anna Hospital Herne, Hospitalstraße 19, 44649, Herne, Germany. Semih.oezdemir@elisabethgruppe.de. 2. Zentrum für Wirbelsäulenchirurgie und Schmerztherapie, Zentrum für Orthopädie und Unfallchirurgie, St. Elisabeth Gruppe-Katholische Kliniken Rhein-Ruhr, St. Anna Hospital Herne, Hospitalstraße 19, 44649, Herne, Germany.
Abstract
OBJECTIVE: Resection of a cervical disc herniation using a full-endoscopic technique with an anterior approach. INDICATION: Fresh disc herniation with monoradicular symptoms in the upper extremity. CONTRAINDICATIONS: Pure neck pain, cervical myelopathy, older and calcified disc herniations, higher grade of instability and deformity. SURGICAL TECHNIQUE: Introduction of a guidewire and dilatator to a cervical disc using an anterior approach. Under full-endoscopic view, preparation of the posterior parts of the annulus, opening of the annulus and posterior longitudinal ligament and resection of the herniated fragment from the epidural space. POSTOPERATIVE MANAGEMENT: Immediate mobilisation, isometric/coordinative exercises, functional exercises from week 3, building up strength from week 6. RESULTS: A total of 120 patients were operated using the full-endoscopic or microsurgically assisted technique and were followed up for 24 months. Significant improvement was achieved in both groups. The group of full-endoscopic operated patients returned to work significantly earlier and 89% of all patients would undergo the operation again.
OBJECTIVE: Resection of a cervical disc herniation using a full-endoscopic technique with an anterior approach. INDICATION: Fresh disc herniation with monoradicular symptoms in the upper extremity. CONTRAINDICATIONS: Pure neck pain, cervical myelopathy, older and calcified disc herniations, higher grade of instability and deformity. SURGICAL TECHNIQUE: Introduction of a guidewire and dilatator to a cervical disc using an anterior approach. Under full-endoscopic view, preparation of the posterior parts of the annulus, opening of the annulus and posterior longitudinal ligament and resection of the herniated fragment from the epidural space. POSTOPERATIVE MANAGEMENT: Immediate mobilisation, isometric/coordinative exercises, functional exercises from week 3, building up strength from week 6. RESULTS: A total of 120 patients were operated using the full-endoscopic or microsurgically assisted technique and were followed up for 24 months. Significant improvement was achieved in both groups. The group of full-endoscopic operated patients returned to work significantly earlier and 89% of all patients would undergo the operation again.