Abstract

Purpose: To demonstrate outpatient 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), performed for treatment of symptomatic herniated cervical disc to be efficacious and safe, and preserves spinal motion. Materials and Methods: Since 1995, 2100 patients (3875 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. Anterior endoscopic microdecompressive cervical discectomy and foraminal decompression technique is described. Non-ablative lower Holmium laser energy was added for disc shrinkage. Results: Average time to return to work was ten to fourteen days. At an average follow-up of 48 months. For single level, 94% had good to excellent symptomatic relief and spinal motion preservation. There were no intraoperative complications. Postoperatively, one patient with transient Horner’s syndrome and one transient hoarseness voice were noted. 6% of patients had persistent neck and upper extremity pain associated with paresthesia, after surgery. Conclusion: This 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), has proven to be safe, less traumatic, easier, and efficacious with significant economic savings. It preserves spinal motion and provides a channel for spinal arthroplasty. It is an effective alternative or replacement for conventional open cervical spinal surgery for discectomy, and can decompress stenosis, in degenerative spine disease.