John C. Chiu M.D., FRCS, D.Sc,
Director, Neurospine Surgery
California Spine Institute Medical Center
Thousand Oaks CA USA

Citation: J. C. Chiu : Endoscopic Microdecompressive Cervical Discectomy and Foraminal Decompression . The Internet Journal of Minimally Invasive Spinal Technology. 2008 Supplement I - to IJMIST Vol 1 No 2

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Abstract

Purpose: To demonstrate outpatient endoscopic microdecompressive cervical discectomy and foraminal decompression, with low energy non-ablative Holmium laser for disc shrinking and tightening effect (laser thermodiskoplasty), performed for treatment of symptomatic herniated cervical disc to be efficacious and safe, and preserves spinal motion. Materials and Methods: Since 1995, 2218 patients (3691 Discs), who failed at least 12 weeks of conservative care were treated. Levels were C2 to C7, inclusive. All patients demonstrated unilateral radicular pain of a specific dermatome, single level or multiple levels, confirmed with EMG/NCV. MRI or CT scans demonstrated the herniated cervical disc. Anterior endoscopic microdecompressive cervical discectomy and foraminal decompression technique is described. Non-ablative lower Holmium laser energy was added for disc shrinkage. Results: Average time to return to work was ten days. At an average follow-up of 4.2 years. For single level, 94% had good to excellent symptomatic relief and spinal motion preservation. There were no intraoperative complications. Postoperatively, one patient with transient Horner's syndrome and one transient hoarseness voice were noted. Seventy five patients (6%) had persistent neck and upper extremity pain associated with parasthesia, after surgery. Conclusion: This endoscopic microdecompressive cervical discectomy and foraminal decompression with added application of non-ablative lower Holmium laser energy for disc shrinkage (laser thermodiskoplasty), has proven to be safe, less traumatic, easier, and efficacious with significant economic savings. It preserves spinal motion and provides a channel for spinal arthroplasty. It is an effective alternative or replacement for conventional open cervical spinal surgery for discectomy, and can decompress stenosis, in degenerative spine disease.