Percutaneous endoscopic cervical discectomy

摘要

The anterior interbody fusion through removal of the intervertebral disc and insertion of a bone graft remains the mainstay of the surgical treatment of extruded soft cervical disc hernia with myelopathy under general anesthesia. However, the open anteromedial discectomy with fusion requires usually to enter into the spinal canal with the risk of complications such as an epidural bleeding, peri-radicular fibrosis, transient or permanent myelopathy, bone graft related problems. The percutaneous endoscopic anterior cervical discotomy with minimally invasive techniques (PECD) under local anesthesia can possibly avoid those complications, and offer an alternative to the open therapeutic methods in cervicobrachial neuralgia or radiculopathy alone due to protruded soft cervical hernia. In case of failure, this operation does not impede the further conventional surgical approaches and it offers numerous advantages with especially the fact that in addition to the absence of the risk of epidural bleeding and of periradicular fibrosis, the stability of the intervertebral mobile segment is maintained, and the risk of recurrence is reduced in performing an anterior discal window. Finally, the time spent in operating room is reduced as well as the duration of hospitalization and the patient can perform again his or her usual activities more rapidly.