Treatment of Spinal Conditions in the Young Adult: Endoscopic Cervical Foraminotomy

Abstract

Minimally invasive cervical foraminotomy procedures have become more prevalent. The goal in treatment of spinal disorders via minimally invasive approaches is motivated by enhancing patient outcome by minimizing pain and complications, facilitating a quicker return to activities, and reducing health care costs. Minimally invasive procedures, specifically microendoscopic foraminotomy surgeries, are excellent for achieving these important goals in young adults. We conducted a literature review of publications regarding endoscopic cervical foraminotomy, as well as including our own experience with the technique. With the development of sequential dilation of muscle fibers using tubular retractor systems and improved endoscopic equipment, minimally invasive procedures can be used safely for posterior cervical decompressions. The semi-sitting position affords decreased blood pooling in the operative field, reduced blood loss, and shorter operative times, and provides improved lateral fluoroscopic images because of the gravity-dependent position of the shoulders. It is critical to identify the correct anatomical level from which the patient׳s radiculopathy originates to achieve surgical success. Minimally invasive procedures, specifically microendoscopic foraminotomy surgeries, are great tools to enhance patient outcome by minimizing pain and complications, facilitating a quicker return to activities, and reducing health care costs. Anterior cervical foraminotomy can be used to treat unilateral radiculopathy; however, there are potential drawbacks with reports of a high reoperation rate. Posterior cervical laminoforaminotomy continues to be an effective option to treat unilateral radiculopathy caused by foraminal stenosis or lateral herniated discs. These minimally invasive procedures have been proven to have success rates equal to or better than those of the traditional open approaches, and are excellent options to treat many patients, especially young adults.