Full Endoscopic Posterior Cervical Foraminotomy in Management of Foraminal Disc Herniation and Foraminal Stenosis

Abstract

Asrafi Rizki Gatam, 1, 2 Luthfi Gatam, 1, 2 Phedy, 1, 2 Harmantya Mahadhipta, 2 Omar Luthfi, 2 Ajiantoro, 2 Syafrudin Husin, 2 Dina Aprilya 3 1Orthopedic Spine Division, Fatmawati General Hospital, Jakarta, Indonesia; 2Orthopaedic and Spine Center Gatam Institute, Eka Hospital BSD, Tangerang, Indonesia; 3Orthopedic and Traumatology, Faculty of Medicine Universitas Indonesia, Jakarta, IndonesiaCorrespondence: Dina AprilyaOrthopedic and Traumatology, Faculty of Medicine Universitas Indonesia, Jakarta, IndonesiaEmail [email protected]: The development of full endoscopic procedures enables surgeons to visualize the operative field very clearly. Posterior foraminotomy using endoscopy was developed as a minimally invasive procedure to reduce the complication of the anterior cervical approach and to preserve the segmental motion without decreasing the effectiveness of nerve decompression. Our aim is to evaluate the result of full endoscopic posterior cervical foraminotomy in our center.Methods: This is a prospective single-arm study of 65 foraminal disc herniation and foraminal stenosis patients that underwent full endoscopic posterior foraminotomy procedures. All patients were routinely observed for 12-months duration to evaluate Visual Analog Score (VAS) of the neck, arm, and modified Macnab criteria.Results: Arm pain VAS decreased significantly compared with the pre-operation state (p < 0.001, 0.034, 0.001 on immediate post-operative, 6-months follow-up, and 12-months follow-up, respectively) even though 6.15% of patients had hypesthesia on follow-up. There was no neck pain observed during 1 year follow-up, and modified Macnab criteria showed a good outcome following full endoscopic posterior foraminotomy.Conclusion: Full endoscopic posterior foraminotomy provides good nerve decompression with all the benefits of endoscopic spine procedure.Keywords: cervical spine, foraminal stenosis, herniated disc, cervical foraminotomy, endoscopic, minimally invasive

Keywords

• cervical spine
• foraminal stenosis
• herniated disc
• cervical foraminotomy
• endoscopic
• minimally invasive.