Abstract
BackgroundCervical radiculopathy is characterized by dysfunction of the nerve root usually caused by a cervical disk herniation. The most important symptom is pain, radiating from the neck to the arm. When conservative treatment fails, surgical treatment is indicated to relieve symptoms. During the last decades, multiple fusion techniques have been developed, although without clinical evidence for added value of fusion over non-fusion.MethodsThe surgical procedure of anterior cervical discectomy without fusion is performed step by step, leading to removal of the entire intervertebral disk.ConclusionAnterior cervical discectomy without fusion is a safe and effective treatment for cervical disk herniation.
Highlights
Cervical radiculopathy is characterized by dysfunction of the nerve root usually caused by a cervical disk herniation
The deep layer surrounds the cervical vertebrae with the paraspinal muscles
The carotid artery, internal jugular vein and vagus nerve are covered within the carotid sheath
Summary
Anterior cervical discectomy without fusion is a safe and effective treatment for cervical disk herniation. The deep cervical fascia invests the deeper layers of the neck (Fig. 1). This area can be further divided into the superficial, middle and deep layers. The jugulum and SCM are marked (Fig. 2), and the appropriate surgical level is identified using fluoroscopy (Fig. 3). A 5-cm skin crease incision is made on the right or left side of the neck, and the platysma is identified in the superficial fascia. When a blunt tip nerve hook with at least 1 mm diameter can be freely introduced into the neuroforamen, the decompression is considered sufficient. If the nerve hook cannot be introduced freely, additional decompression is necessary (Fig. 5).
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