Full endoscopic surgery for cervical radiculopathy due to disc herniation -clinical results and technical considerations-

Abstract

Introduction: Cases of posterior surgery for cervical radiculopathy using FED (Full Endoscopic Discectomy) were retrospectively reviewed.

Methods: Seven patients that underwent posterior decompression surgery using FED systems have completed 12 months follow up. All of the patients were suffered from radiculopathy due to cervical disc herniation.

Results: Mean surgical time was 97 minutes and bleeding was minimum in all cases. Average radiculopathy scores of the patients before surgery was 10.8, which was improved to 17.5 at three months and 18.0 at one year.

Discussion: Surgery using FED systems has several advantages compared to other methods. Closer view point to the neural tissue makes it possible to observe neural structures more clearly, thus makes the procedure safer and more comfortable. To appreciate this advantage, precise orientation and strict bleeding control are mandatory. Perfusion used in FED surgery enables releasing vessels from other surrounding tissues by hydrostatic pressure, making it easier to control bleeding from epidural vessels. Although small diameter of the device gives benefit on FED surgery, this feature can result in higher possibility of wrong level surgery or migration of the scope into spinal canal. Thus this technique should be carefully performed to prevent neurologic complications and enough training will be required.

Conclusions: Deep and closer eye point is a substantial advantage in FED surgery.