Original Article

Endoscopic Anterior Cervical Discectomy/Foraminoplasty With Intraoperative Neurophysiological Monitoring (IOM)

J Chiu

Citation

J Chiu. Endoscopic Anterior Cervical Discectomy/Foraminoplasty With Intraoperative Neurophysiological Monitoring (IOM). The Internet Journal of Minimally Invasive Spinal Technology. 2010 Volume 4 Number 1.

Abstract

INTRODUCTION: To demonstrate outpatient anterior endoscopic microdecompressive cervical discectomy and foraminal decompression (foraminoplasty), by utilizing GPS (grid positional system), can treat herniated cervical discs and cervical foraminal stenosis efficaciously and successfully.MATERIALS-METHODS: Since 1995, 2066 patients (3730 Discs), who failed at least 12 weeks of conservative care were treated. Levels were C2 to C7, inclusive. All patients demonstrated unilateral radicular pain of a specific dermatome, single level or multiple levels, confirmed with EMG/NCV. MRI or CT scans demonstrated the herniated cervical disc. The surgical technique of anterior endoscopic microdecompressive cervical discectomy foraminal decompression (foraminoplasty) and laser thermodiskoplasty (non-ablative lower Holmium laser energy for disc shrinkage and tightening) are described. The surgical approach guided and facilitated with GPS is explained.RESULTS: For single level, 94% had good to excellent symptomatic relief and spinal motion preservation. 6% of patients had some persistent neck and upper extremity residual but diminished pain associated with parasthesia, after surgery. Average time to return to work was ten to fourteen days. There were no intraoperative complications. Postoperatively, one with transient Horner’s syndrome and one transient hoarseness voice were noted. CONCLUSION: Anterior endoscopic microdecompressive cervical discectomy and foraminal decompression with mechanical decompression and lower level non-ablative Holmium laser for disc shrinking and tightening effect (laser thermodiskoplasty) with GPS has proven to be safe, less traumatic, easier, and efficacious with significant economic savings. It preserves spinal motion. It is an effective alternative or replacement for conventional open cervical spinal surgery for discectomy.

 

References

Author Information

John C. Chiu
California Spine Institute

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