Abstract

Cervical myelopathy and/or cervical radiculopathy caused by compressing lesions such as cervical spondylosis with secondary spinal stenosis or herniated cervical disc were surgically treated either by a posterior laminectomy, sometimes with laminoplasty, or by an anterior approach with or without interbody fusion or corporectomy. Considering the complications and the outcomes in the open spinal surgery, we introduced in 1989 “closed” surgical techniques. With minimally invasive spinal surgery the trauma for the patient is minimized and consequently iatrogenic effects may be avoided. This surgery enables the surgeon to easy reach all the spinal structures, reducing the risk of complications and avoiding the formation of postoperative scar tissue and secondary spinal instability. In the present study we report our results using endoscopic microsurgey in herniated cervical discs. This work was carried out from January 1991 to December 2003. Four hundred and ninety-six patients should have undergone to traditional surgery for 720 herniated cervical discs. They were, instead, treated by using the endoscopic technique. In 697 herniations the surgical procedure was performed by a paramidline right anterior approach and in 23 herniations by a paramidline posterior approach. We had very good results without considerable complications. There were three cases of reoperation during the follow-up period of these patients. We resume that this endoscopic method applied to the cervical spine is extremely advantageous and safe.