This minimally-invasive surgical procedure, performed through a tiny hole in the neck, removes the bulging portion of a herniated cervical disc. It is designed to relieve neck and radiating arm pain caused by herniated disc material pressing on nerve roots.
The patient is positioned so that the surgeon has access to the front of the neck. Anesthesia is administered, and the neck is cleaned and sterilized. Vital structures in the neck are pushed aside. The surgeon inserts a needle into the neck, and, using a fluoroscope to confirm the needle's position, carefully guides it a short distance to the surface of the disc. A guide wire is inserted through the needle and into the disc. The needle is removed. The surgeon slides a small dilator tube over the guide wire and pushes it down to the disc. A working sleeve is pushed over the dilator, and the dilator is removed. Surgical tools and a tiny endoscope are pushed through the working sleeve into the disk. Using the view from the endoscope, the surgeon carefully removes the bulging portion of the disc. This relieves pressure on surrounding nerve roots. The instruments are removed, and the opening is covered with a small bandage. Pain relief may begin immediately after the procedure. The patient may wear a cervical neck brace for a few weeks while recovering.