gms | German Medical Science

Objective: In osseous foraminal stenosis in the cervical spine, posterior foraminotomy represent a valuable option. Here the authors present their technique and results with a shear endoscopic technique in selected cases.

Method: Forty patients suffering from cervical osseous neural foraminal stenosis were operated on via a posterior approach with the EasyGO^® endoscopic system. Fifty percent of patients had anterior cervical surgery in the past. Twenty-nine patients had single segment, ten patients had two segments and one patient had three segments surgery. All procedures were video recorded and afterwards retrospectively analyzed. Additionally particular reference was given to postoperative outcome, wound healing with cosmetic results and complications.

Results: In all patients, the endoscopic system was easy to handle intraoperatively. No emergency stopping was required. Due to hardware problems, one procedure had to be switched to microsurgical technique. Neither dural tear nor nerve root injury was observed. No new neurological deficit occurred. In one patient, a transient worsening of his preoperative triceps paresis was seen but the paresis completely recovered at three months follow-up. One patient had a revision surgery due to postoperative bleeding. In 95% of cases, immediate pain relief was documented. In 85% of cases no or improved paresis was documented.

Conclusions: The EasyGO^® system was easy and safe to handle. The endoscopic results are comparable with microsurgery procedures with respect to pain relieve and long-term effect. However, endoscopic posterior techniques offer minimal muscular trauma and superior cosmetic results. They should be anticipated as a good alternative to microsurgical decompression particularly in posterior approaches to cervical foraminal stenosis.