Skip to main content

Posteriorly Approached Cervical Endoscopy

  • Chapter
  • First Online:
Endoscopic Procedures on the Spine

Abstract

Posterior cervical foraminotomy is a well-known surgical procedure for patients with radiculopathy. Nowadays, improved surgical techniques and instruments enable minimally invasive posterior cervical foraminotomy. Minimizing disruption of posterior cervical structures during the procedures may improve the short-term and long-term outcomes of the posterior approaching surgery. In this chapter we are going to introduce posterior percutaneous endoscopic cervical discectomy and foraminotomy (PECF), and show clinical and radiological outcomes. PECF is indicated for patient with cervical unilateral radiculopathy which is confined to one to three levels. Preconditions are minimal degeneration at both disc and facet joint. Good surgical outcomes can be expected when PECF is performed for patients with appropriate indications. PECF may serve as a good alternative surgical technique with equivalent outcome to the conventional ACDF for patients with unilateral radiculopathy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Hilibrand AS, Carlson GD, Palumbo MA, Jones PK, Bohlman HH. Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am. 1999;81:519–28.

    Article  CAS  PubMed  Google Scholar 

  2. Kraemer P, Fehlings MG, Hashimoto R, et al. A systematic review of definitions and classification systems of adjacent segment degeneration. Spine (Phila Pa 1976). 2012;37:S31–9.

    Article  Google Scholar 

  3. Cho SK, Riew KD. Adjacent segment disease following cervical spine surgery. J Am Acad Orthop Surg. 2013;21:3–11.

    Article  PubMed  Google Scholar 

  4. Tureyen K. Disc height loss after anterior cervical microdiscectomy with titanium intervertebral cage fusion. Acta Neurochir. 2003;145:565–9; discussion 9-70

    Article  CAS  PubMed  Google Scholar 

  5. Hilibrand AS, Robbins M. Adjacent segment degeneration and adjacent segment disease: the consequences of spinal fusion? Spine J. 2004;4:190S–4S.

    Article  PubMed  Google Scholar 

  6. Matsumoto M, Okada E, Ichihara D, et al. Anterior cervical decompression and fusion accelerates adjacent segment degeneration: comparison with asymptomatic volunteers in a ten-year magnetic resonance imaging follow-up study. Spine (Phila Pa 1976). 2010;35:36–43.

    Article  Google Scholar 

  7. Zhu Y, Zhang B, Liu H, Wu Y, Zhu Q. Cervical disc arthroplasty versus anterior cervical discectomy and fusion for incidence of symptomatic adjacent segment disease: a meta-analysis of prospective randomized controlled trials. Spine (Phila Pa 1976). 2016;41:1493–502.

    Article  Google Scholar 

  8. Riew KD, Schenk-Kisser JM, Skelly AC. Adjacent segment disease and C-ADR: promises fulfilled? Evid Based Spine Care J. 2012;3:39–46.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kong L, Ma Q, Meng F, Cao J, Yu K, Shen Y. The prevalence of heterotopic ossification among patients after cervical artificial disc replacement: a systematic review and meta-analysis. Medicine (Baltimore). 2017;96:e7163.

    Article  Google Scholar 

  10. Harrod CC, Hilibrand AS, Fischer DJ, Skelly AC. Adjacent segment pathology following cervical motion-sparing procedures or devices compared with fusion surgery: a systematic review. Spine (Phila Pa 1976). 2012;37:S96–S112.

    Article  Google Scholar 

  11. Lee JH, Park WM, Kim YH, Jahng TA. A biomechanical analysis of an artificial disc with a shock-absorbing core property by using whole-cervical spine finite element analysis. Spine (Phila Pa 1976). 2016;41:E893–901.

    Article  Google Scholar 

  12. Lee SE, Chung CK, Jahng TA. Early development and progression of heterotopic ossification in cervical total disc replacement. J Neurosurg Spine. 2012;16:31–6.

    Article  PubMed  Google Scholar 

  13. Richards O, Choi D, Timothy J. Cervical arthroplasty: the beginning, the middle, the end? Br J Neurosurg. 2012;26:2–6.

    Article  CAS  PubMed  Google Scholar 

  14. Park SB, Kim KJ, Jin YJ, Kim HJ, Jahng TA, Chung CK. X-ray-based kinematic analysis of cervical spine according to prosthesis designs: analysis of the Mobi C, Bryan, PCM, and Prestige LP. J Spinal Disord Tech. 2015;28:E291–7.

    Article  PubMed  Google Scholar 

  15. Mehren C, Suchomel P, Grochulla F, et al. Heterotopic ossification in total cervical artificial disc replacement. Spine (Phila Pa 1976). 2006;31:2802–6.

    Article  Google Scholar 

  16. Jho HD, Kim MH, Kim WK. Anterior cervical microforaminotomy for spondylotic cervical myelopathy: part 2. Neurosurgery. 2002;51:S54–9.

    PubMed  Google Scholar 

  17. Jho HD, Kim WK, Kim MH. Anterior microforaminotomy for treatment of cervical radiculopathy: part 1-disc-preserving “functional cervical disc surgery”. Neurosurgery. 2002;51:S46–53.

    PubMed  Google Scholar 

  18. Lubelski D, Healy AT, Silverstein MP, et al. Reoperation rates after anterior cervical discectomy and fusion versus posterior cervical foraminotomy: a propensity-matched analysis. Spine J. 2015;15:1277–83.

    Article  PubMed  Google Scholar 

  19. Wirth FP, Dowd GC, Sanders HF, Wirth C. Cervical discectomy. A prospective analysis of three operative techniques. Surg Neurol. 2000;53:340–6; discussion 6-8.

    Article  CAS  PubMed  Google Scholar 

  20. Liu WJ, Hu L, Chou PH, Wang JW, Kan WS. Comparison of anterior cervical discectomy and fusion versus posterior cervical foraminotomy in the treatment of cervical radiculopathy: a systematic review. Orthop Surg. 2016;8:425–31.

    Article  PubMed  Google Scholar 

  21. Mansfield HE, Canar WJ, Gerard CS, O’Toole JE. Single-level anterior cervical discectomy and fusion versus minimally invasive posterior cervical foraminotomy for patients with cervical radiculopathy: a cost analysis. Neurosurg Focus. 2014;37:E9.

    Article  PubMed  Google Scholar 

  22. Witzmann A, Hejazi N, Krasznai L. Posterior cervical foraminotomy. A follow-up study of 67 surgically treated patients with compressive radiculopathy. Neurosurg Rev. 2000;23:213–7.

    Article  CAS  PubMed  Google Scholar 

  23. Peto I, Scheiwe C, Kogias E, Hubbe U. Minimally invasive posterior cervical foraminotomy: Freiburg experience with 34 patients. Clin Spine Surg. 2017;30:E1419–25.

    Article  PubMed  Google Scholar 

  24. Won S, Kim CH, Chung CK, et al. Comparison of cervical sagittal alignment and kinematics after posterior full-endoscopic cervical foraminotomy and discectomy according to preoperative cervical alignment. Pain Physician. 2017;20:77–87.

    Article  PubMed  Google Scholar 

  25. Jagannathan J, Sherman JH, Szabo T, Shaffrey CI, Jane JA. The posterior cervical foraminotomy in the treatment of cervical disc/osteophyte disease: a single-surgeon experience with a minimum of 5 years’ clinical and radiographic follow-up. J Neurosurg Spine. 2009;10:347–56.

    Article  PubMed  Google Scholar 

  26. Riew KD, Cheng I, Pimenta L, Taylor B. Posterior cervical spine surgery for radiculopathy. Neurosurgery. 2007;60:S57–63.

    Article  PubMed  Google Scholar 

  27. Yang JS, Chu L, Chen L, Chen F, Ke ZY, Deng ZL. Anterior or posterior approach of full-endoscopic cervical discectomy for cervical intervertebral disc herniation? A comparative cohort study. Spine (Phila Pa 1976). 2014;39:1743–50.

    Article  Google Scholar 

  28. Kim KT, Cho DC, Sung JK, Kim YB, Kim DH. Comparative analysis between total disc replacement and posterior foraminotomy for posterolateral soft disc herniation with unilateral radiculopathy: clinical and biomechanical results of a minimum 5 years follow-up. J Korean Neurosurg Soc. 2017;60:30–9.

    Article  PubMed  Google Scholar 

  29. Ruetten S, Komp M, Merk H, Godolias G. Full-endoscopic anterior decompression versus conventional anterior decompression and fusion in cervical disc herniations. Int Orthop. 2009;33:1677–82.

    Article  PubMed  Google Scholar 

  30. Park YK, Moon HJ, Kwon TH, Kim JH. Long-term outcomes following anterior foraminotomy for one- or two-level cervical radiculopathy. Eur Spine J. 2013;22:1489–96.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Kim KT, Kim YB. Comparison between open procedure and tubular retractor assisted procedure for cervical radiculopathy: results of a randomized controlled study. J Korean Med Sci. 2009;24:649–53.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Ruetten S, Komp M, Merk H, Godolias G. Full-endoscopic cervical posterior foraminotomy for the operation of lateral disc herniations using 5.9-mm endoscopes: a prospective, randomized, controlled study. Spine (Phila Pa 1976). 2008;33:940–8.

    Article  Google Scholar 

  33. Won S, Kim CK, Chung CK, et al. Clinical outcomes of single-level posterior percutaneous endoscopic cervical foraminotomy for patients with less cervical lordosis. J Minim Invasive Spine Surg Tech. 2016;1:11–7.

    Article  Google Scholar 

  34. Kim CH, Shin KH, Chung CK, Park SB, Kim JH. Changes in cervical sagittal alignment after single-level posterior percutaneous endoscopic cervical diskectomy. Global Spine J. 2015;5:31–8.

    Article  PubMed  Google Scholar 

  35. Kim CH, Kim KT, Chung CK, et al. Minimally invasive cervical foraminotomy and diskectomy for laterally located soft disk herniation. Eur Spine J. 2015;24:3005–12.

    Article  PubMed  Google Scholar 

  36. Kim CH, Chung CK, Kim HJ, Jahng TA, Kim DG. Early outcome of posterior cervical endoscopic discectomy: an alternative treatment choice for physically/socially active patients. J Korean Med Sci. 2009;24:302–6.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Ruetten S, Komp M, Merk H, Godolias G. A new full-endoscopic technique for cervical posterior foraminotomy in the treatment of lateral disc herniations using 6.9-mm endoscopes: prospective 2-year results of 87 patients. Minim Invasive Neurosurg. 2007;50:219–26.

    Article  CAS  PubMed  Google Scholar 

  38. Clark JG, Abdullah KG, Steinmetz MP, Benzel EC, Mroz TE. Minimally invasive versus open cervical foraminotomy: a systematic review. Global Spine J. 2011;1:9–14.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Miyazaki M, Hong SW, Yoon SH, Morishita Y, Wang JC. Reliability of a magnetic resonance imaging-based grading system for cervical intervertebral disc degeneration. J Spinal Disord Tech. 2008;21:288–92.

    Article  PubMed  Google Scholar 

  40. Park MS, Moon SH, Kim TH, Lee SY, Jo YG, Riew KD. Relationship between modic changes and facet joint degeneration in the cervical spine. Eur Spine J. 2015;24:2999–3004.

    Article  PubMed  Google Scholar 

  41. Skovrlj B, Gologorsky Y, Haque R, Fessler RG, Qureshi SA. Complications, outcomes, and need for fusion after minimally invasive posterior cervical foraminotomy and microdiscectomy. Spine J. 2014;14:2405–11.

    Article  PubMed  Google Scholar 

  42. Zdeblick TA, Zou D, Warden KE, McCabe R, Kunz D, Vanderby R. Cervical stability after foraminotomy. A biomechanical in vitro analysis. J Bone Joint Surg Am. 1992;74:22–7.

    Article  CAS  PubMed  Google Scholar 

  43. Hwang JC, Bae HG, Cho SW, Cho SJ, Park HK, Chang JC. Morphometric study of the nerve roots around the lateral mass for posterior foraminotomy. J Korean Neurosurg Soc. 2010;47:358–64.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Tanaka N, Fujimoto Y, An HS, Ikuta Y, Yasuda M. The anatomic relation among the nerve roots, intervertebral foramina, and intervertebral discs of the cervical spine. Spine (Phila Pa 1976). 2000;25:286–91.

    Article  CAS  Google Scholar 

  45. McAnany SJ, Kim JS, Overley SC, Baird EO, Anderson PA, Qureshi SA. A meta-analysis of cervical foraminotomy: open versus minimally-invasive techniques. Spine J. 2015;15:849–56.

    Article  PubMed  Google Scholar 

  46. Kim RH, Kim CH, Choi Y, et al. The incidence and risk factors for lumbar or sciatic scoliosis in lumbar disc herniation and the outcomes after percutaneous endoscopic discectomy. Pain Physician. 2015;18:555–64.

    PubMed  Google Scholar 

  47. Ahn Y, Lee SH, Lee SC, Shin SW, Chung SE. Factors predicting excellent outcome of percutaneous cervical discectomy: analysis of 111 consecutive cases. Neuroradiology. 2004;46:378–84.

    Article  CAS  PubMed  Google Scholar 

  48. Lee JH, Lee SH. Clinical and radiographic changes after percutaneous endoscopic cervical discectomy: a long-term follow-up. Photomed Laser Surg. 2014;32:663–8.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Chi Heon Kim .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Won, S., Kim, C.H., Chung, C.K. (2020). Posteriorly Approached Cervical Endoscopy. In: Kim, JS., Lee, J., Ahn, Y. (eds) Endoscopic Procedures on the Spine. Springer, Singapore. https://doi.org/10.1007/978-981-10-3905-8_5

Download citation

  • DOI: https://doi.org/10.1007/978-981-10-3905-8_5

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-3904-1

  • Online ISBN: 978-981-10-3905-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics