Abstract

Study Design: Antero-lateral approach with discectomy is the first step of most surgical procedures used to treat cervical degenerative diseases. In order to avoid discectomy, endoscopic posterior foraminotomy has been used from 2002 to February 2006. Since this date endoscopic anterior foraminotomy is routinely performed for any kind of degenerative diseases: soft or hard disc prolapses and foraminal stenosis. This study is to report our experience with this approach. Material and Methods: The device (Endospine, Karl Storz GmbH, Tuttlingen, Germany) is composed of three tubes: one for the endoscope, one for suction and the largest one for classical surgical instruments. From February to December 2006, twenty patients suffering from cervical radiculopathy have been treated by endoscopic anterior foraminotomy, using Jho's technique. Mean age is 43, sex ratio F/M is 3/1. The level of compression was C4-C5 in 1 case, C5-C6 in 10 and C6-C7 in 9 cases. Radiculopathy was right in 11 cases and left in 9. In 2 cases severe stenosis without disc prolapse was the cause of the pain, in the others disc prolapse was the main cause of the pain. Results: Radicular pain disappeared in all patients with transient numbness in 2. No Horner's syndrome occurred. One dural tear was treated successfully by compression with Surgicel. Conclusions: These excellent results combined with almost no complication and the ability to use this technique for any kind of degenerative desease have led us to use it routinely and to reserve posterior endoscopic approach to soft C7-T1 disc. Nevertheless these advantages must be confirmed by long term results.