Decompression for cervical disc herniation using the full-endoscopic anterior technique.

OBJECTIVE: Resection of a cervical disc herniation using a full-endoscopic technique with an anterior approach.

INDICATION: Fresh disc herniation with monoradicular symptoms in the upper extremity.

CONTRAINDICATIONS: Pure neck pain, cervical myelopathy, older and calcified disc herniations, higher grade of instability and deformity.

SURGICAL TECHNIQUE: Introduction of a guidewire and dilatator to a cervical disc using an anterior approach. Under full-endoscopic view, preparation of the posterior parts of the annulus, opening of the annulus and posterior longitudinal ligament and resection of the herniated fragment from the epidural space.

POSTOPERATIVE MANAGEMENT: Immediate mobilisation, isometric/coordinative exercises, functional exercises from week 3, building up strength from week 6.

RESULTS: A total of 120 patients were operated using the full-endoscopic or microsurgically assisted technique and were followed up for 24 months. Significant improvement was achieved in both groups. The group of full-endoscopic operated patients returned to work significantly earlier and 89% of all patients would undergo the operation again.