Safety and Efficacy of Endoscopic Posterior Cervical Discectomy and Foraminotomy Using Three-Point Plaster Traction Technique

Abstract

The endoscopic posterior cervical foraminotomy and discectomy have been continuously developed and are considered widely performed minimally invasive procedures while maximally preserving patients’ anatomical structures. In posterior cervical spine surgery, the Mayfield head clamp is commonly used to provide a rigid, stable position of the head throughout the procedure. The use of the Mayfield head clamp has been associated with skull fractures, lacerations, air embolisms and epidural hematoma. However, we have performed 12 surgeries without Mayfield head clamp, in order to reduce the amount of equipment preparation needed and the additional risk of complications resulting from skeletal traction during surgery. These 12 patients were operated between January 2016 and February 2017 with full-endoscopic posterior discectomy or foraminotomy for posterolateral disc herniation or foraminal stenosis by osteophytes. In all 12 patients, preoperative average VAS scores were 7.67±1.4 for the neck and 8.33±1.1 for the arm, while postoperative VAS scores were 1.8±0.7 for the neck and 1.4±2 for the arm. All patients underwent a 6-month follow-up, during which improvement in VAS scores was maintained. There was no compromise in endoscopic view during surgery due to our positioning technique. Our results show that posterior cervical endoscopic spine surgery can be performed safely and effectively with three-point plaster traction technique without risks associated with skeletal traction.

Keywords

• cervical
• discectomy
• foraminotomy
• skeletal traction
• endoscopy