Anterior cervical microforaminotomx: Disc preservation technique

Abstract

Ideal surgical treatment for a cervical disc herniation would be complete removal of ruptured disc fragments or spondylotic bony spurs although the remaining intervertebral disc would be preserved to maintain the motion segment. Conventional surgical treatment for a cervical disc herniation has been either an anterior discectomy with or without bone graft fusion or a posterior foraminotomy. Neither of the conventional surgical treatments are ideal because the anterior discectomy technique sacrifices a motion segment completely, and the posterior foraminotomy technique provides limited access to compressive lesions. An anterior cervical foraminotomy technique was developed to achieve those ideal goals by Dr Jho. Jho's anterior foraminotomy is approached in a way that is very similar to the conventional anterior cervical discectomy. However, instead of complete removal of the intervertebral disc, a small anterior foraminotomy hole is made at the unilteral uncovertebral joint. Only herniated disc fragments or compressing bony spurs are removed via a 5-mm anterior foraminotomy hole under the operating microscope. The nerve root is decompressed under direct vision along the segment from its origin at the spinal cord to the exit site behind the vertebral artery. The remaining intervertebral disc is preserved to maintain the functioning motion unit. Jho's anterior cervical foraminotomy technique is described in this report along with the experience of more than 100 patients.