Anterior transcorporeal approach combined with posterior translaminar approach in percutaneous endoscopic cervical discectomy for two‑segment cervical disc herniation treatment: a technical report and early follow‑up

Journal of Orthopaedic Surgery and Research, 2024 · DOI: https://doi.org/10.1186/s13018-023-04471-4 · Published: January 5, 2024

Surgery Orthopedics Spinal Disorders

Simple Explanation

This study introduces a novel full endoscopic technique combining anterior and posterior approaches for treating mixed-type two-segment cervical disc herniation (MTCDH). MTCDH is when one disc herniates in front of the spinal cord, and another herniates behind it. The combined technique aims to relieve spinal cord compression via minimally invasive surgery. This method avoids vertebral body fusion and preserves vertebral motion segments, reducing damage to the cervical disc. Thirty patients with MTCDH underwent this procedure with at least 12 months of follow-up. Results showed significant symptom and pain reduction post-operatively, with imaging confirming bone repair and increased cervical Cobb angle, and no serious complications.

Study Duration

12 months

Participants

30 patients with mixed-type two-segment cervical disc herniation (MTCDH)

Evidence Level

Not specified

Key Findings

1
Patients experienced significant symptom and pain reduction post-operatively, as indicated by clinical assessment scales.
2
Imaging results demonstrated bony repair of surgically induced bone defects and an increase in the cervical Cobb angle.
3
The study found no serious complications associated with the combined surgical technique.

Research Summary

The study introduces a combined anterior transcorporeal and posterior translaminar approach for full endoscopic treatment of mixed-type two-segment cervical disc herniation (MTCDH). The technique aims to achieve minimally invasive decompression, avoid vertebral body fusion, preserve vertebral motion segments, and minimize damage to the cervical disc. Results from 30 patients showed significant symptom relief, bony repair, increased cervical Cobb angle, and no serious complications, demonstrating the technique's feasibility and effectiveness.

Practical Implications

Expanded Scope of Endoscopic Technology

The technique expands the application of full endoscopic technology in cervical surgery by addressing mixed-type two-segment cervical disc herniations.

Minimally Invasive Decompression

The combined approach allows for minimally invasive decompression, reducing the need for fusion and preserving vertebral motion segments.

Reduced Risk of Adjacent Segment Disease

By avoiding fusion and internal fixation, the technique minimizes biomechanical changes in the cervical spine, potentially reducing the risk of adjacent segment disease.

Study Limitations

1
The technique still carries risks associated with both anterior and posterior cervical complications, despite reducing damage to soft tissues.
2
Minor impairment to the discs and annulus fibrosus is unavoidable.
3
The steep learning curve and high surgical skill requirement may hinder the dissemination of the technology.

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