The Fullendoscopic Anterior Cervical Fusion: A New Horizon for Selective Percutaneous Endoscopic Cervical Decompression

Abstract

As a bridge between open and percutaneous therapy, endoscopy of the cervical spine started to be used at the beginning of the 1990s, following good experiences on the lumbar spine. The principle of microsurgery is combined with the minimally invasive principles by bringing the optical level to the forefront of pathology. Access morbidity has been significantly reduced by the percutaneous access technique. However, this procedure cannot be applied in patients with cervical disc herniation accompanied by segmental instability.

In further developing these endoscopic techniques, in view of the experiences with the classical “Cloward procedure”, the aim was to do a bony fusion of the intervertebral space of the cervical spine by endoscopic access.

Material: A female patient with postraumatic instability of the cervical segments C4/5 underwent a fullendoscopic bony fusion. The technique will be described. The fusional process has been documented by CT and clinical assessment over 3 months.

Result: Having preoperative pain of VAS 8, it diminished to VAS 1 after surgery. The Ct-controls demonstrated a good placement of the bony dowel through the endoscopic sheath in the intervertebral space. After 3 months a bony fusion was documented by CT and in bending X-ray.

Conclusion: The result of this method displays that a fullendoscopic fusion of the cervical spine with a bone dowel is possible. The clinical result seems to be comparable to the classical Cloward procedure. To the best of my knowledge, this is the first report of a fullendoscopic osseous fusion on the cervical spine.