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Cervical Endoscopic Laminotomy and Discectomy

What does “Cervical Endoscopic Laminotomy and Discectomy” mean?

  1. Cervical: part of the spine in the neck
  2. Endoscopic: use of a small fiberoptic tube during surgery to be able to see the inside of the spine.
  3. Laminotomy: removal of a piece of the lamina bone from the back of the spine
  4. Discectomy: removal of a piece of disc material from the spine

Altogether, “Cervical Endoscopic Laminotomy and Discectomy” means removing a small piece of the lamina bone of the neck in order to locate and remove a disc herniation using a fiberoptic tube.

What is a Cervical Endoscopic Laminotomy and Discectomy?

A cervical endoscopic discectomy is a minimally invasive surgery done from the back of the neck (cervical spine). A small tube is placed in the back of the neck down to the lamina bone. A piece of the lamina bone is removed to see the spinal nerve and disc material below it. The spinal nerve is then freed up from the herniated disc material which is removed. A fiberoptic tube is used to see the inside of the spine.

Why is a Cervical Endoscopic Laminotomy and Discectomy done?

A cervical endoscopic discectomy is done for a disc herniation in the neck which is irritating or compressing a spinal nerve.

What is the difference between an Endoscopic Cervical Laminotomy and Discectomy and other types of Cervical Discectomies?

Percutaneous and Endoscopic Cervical Discectomies typically require that the disc itself is salvageable. This means, that even though the disc is diseased by a disc herniation, the disc as a whole can still function as a shock absorber once the herniation is removed. An Anterior Cervical Discectomy and Fusion (ACDF) removes the entire disc since the disc is deemed non-salvageable.

  1. An Anterior Cervical Endoscopic Discectomy is done from the front of the spine. It is a minimally invasive spine surgery which removes disc material from a protruding or herniated disc in the neck. It uses a small endoscope to see inside the disc and small graspers (forceps) placed through the endoscope to remove the disc material.
  2. A Cervical Percutaneous Discectomy is done through a needle placed into the disc from the front of the spine. This procedure uses a small needle like device (e.g. nucleoplasty wand) to remove disc material with the help of an X-Ray machine. It does not remove much disc material and does not put anything into the disc.
  3. A Cervical Endoscopic Discectomy is done from the back of the spine. Tubes are placed into the spine to gain access to the disc and requires removing a small portion of bone (laminotomy) in the process. It is a minimally invasive procedure which uses small instruments to remove a piece of disc. This procedure can remove more disc material than a Cervical Percutaneous Discectomy. The disc can also be seen with the endoscope.
  4. An Anterior Cervical Discectomy and Fusion (ACDF) is an open surgery, not minimally invasive. It is done from the front of the spine. An incision and dissection is required (dividing tissue to see the next structure below). An ACDF surgery removes most of the disc and then places bone or bone-like material into the space to allow it to fuse together (become one piece of bone).

How is an Endoscopic Cervical Laminotomy and Discectomy surgery actually done?

  1. An intravenous catheter (IV) is placed and antibiotics are given.
  2. This surgery is done in an Operating Room.
  3. The patient is placed under General Anesthesia while lying on their back (supine)
  4. The patient is then carefully placed on their stomach (prone) on the operating table. Some surgeons perform this surgery with the patient in a sitting position.
  5. The head and neck are carefully positioned to make the approach for surgery as good as possible.
  6. The back of the neck is now cleaned with a surgical antiseptic and plastic covers (drapes) are placed around the area where the surgery will take place.
  7. With the help of an X-Ray machine, the correct spinal level is found and a small cut (incision) is made. A small metal wire placed through the cut and onto the lamina bone.
  8. Small tubes of increasing diameter are then placed over the wire to make the area wider (dilate). The final, largest tube is placed and the wire removed.
  9. The endoscope is placed through the largest tube down to the lamina bone.
  10. A small piece of the lamina bone is removed. The spinal nerve can now be seen.
  11. The spinal nerve is carefully inspected and the herniated disc material removed.
  12. The main part of the surgery is now complete.
  13. The endoscope and tube is removed.
  14. The small cut is closed with stitches (sutures)
  15. A bandage (dressing) is place over the wound.
  16. The patient is carefully rolled onto the back (supine) and awoken from Anesthesia.
  17. The patient is then taken to the Recovery Room.

How long does a surgery like this typically take?

A cervical endoscopic laminotomy and discectomy can typically take 1-2 hours to complete for one spinal level.

What is the recovery from an Endoscopic Cervical Laminotomy and Discectomy like?

  1. This surgery can be done as an outpatient or an overnight admission to the hospital.
  2. Usually neck braces are not necessary.
  3. The motion in the neck may be somewhat limited for a short period of time.
  4. The surgeon will usually evaluate the patient within a few weeks after surgery.
  5. The wound from the surgery will typically heal within 2 weeks.
  6. The symptoms from the disc herniation (pain, numbness, weakness) usually improve quickly, but can take weeks to months to reach the maximum level of improvement.

What type of benefit can patients gain from this procedure?

Patients can get improvement in neck and arm pain caused by a herniated disc in the neck. This benefit could be for the long term.