Endoscopic Cervical Foraminotomy Using Endoscopic Discectomy(MED) System In Cadevaric Specimens.

Roh, Sung Woo; Rhim, Seung Chul

Original Article

Journal of Korean Neurosurgical Society 1999;28(8): 1100-1105.

Department of Neurological Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.

ABSTRACT

OBJECTIVE
This study was undertaken to evaluate the feasibility of minimally invasive posterior surgical approach for cervical disc diseases.
METHODS
The authors performed cervical key hole foraminotomies using the microendoscopic discectomy (MED) system in four cadaveric cervical spine specimens. Three non-contiguous cervical nerve roots were selected between C3 and C8 in each specimen and were decompressed using MED system on one side. Contralateral sides were decompressed using the open foraminotomy procedure. The amount of bony decompression achieved with the MED system was compared to that achieved with the open foraminotomy procedure in each cadaveric specimen.
RESULTS
Postop CT-myelogram and postoperative open dissection showed adequate bony decompression was achieved with either the MED or open procedure in all specimens. The laminotomy size(vertical and transverse diameter), the length of decompressed nerve root, and the proportion of removed facet joint were measured on every operated level. The average vertical diameter of laminotomy area and the percentage of facet removed were significantly greater in the MED procedure than the open procedure(p<0.05). The transverse diameter of the laminotomy area and the average decompressed root length were not significantly different between MED and open surgery.
CONCLUSION
We conclude endoscopic cervical foraminotomy using the MED system is a feasible procedure and may be applicable to the treatment of foraminal stenosis and laterally located cervical disc herniation in clinical settings.

Key Words: Posterior cervical foraminotomy; MED system; Foraminal stenosis; Cervical disc herniation