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Endoscopic Anterior Cervical Discectomy (Disc Preserving)

Background and Introduction: Endoscopic anterior cervical approach has several advantages compared to conventional anterior cervical discectomy and fusion (ACDF). Objective: This video demonstrates a step-by-step procedure for endoscopic anterior cervical discectomy. Procedure: The patient is placed supine with the neck extended. A standard anterior cervical approach using about 3 cm skin incision is made and under “Easy Go” (Karl Storz, Tuttlingen, Germany) endoscopic vision, the uncinate process and uncus are drilled. Only a small portion of the normal disc, posterior longitudinal ligament (PLL), and compressing disc is removed. The closure is done in a standard manner. Results: In 240 patients, the average postoperative reduction in disc height, operating time, and blood loss were 1.1 ± 0.2 mm, 110 ± 17 min, and 30 ± 11 mL, respectively. The average postoperative VAS score and Nurick grading improved significantly. There were no permanent complications or any mortality. Conclusion: Endoscopic technique is an effective and safe alternative to ACDF after attaining the learning curve.