Long-term clinical and radiological follow-up after anterior endoscopic cervical discectomy: a case report

Anterior endoscopic cervical discectomy (AECD) using laser and micro forceps for cervical intervertebral disc herniation has been considered as an effective treatment modality in selected cases. However, several spine surgeons are concerned about the adverse outcomes of discectomy without fusion, such as postoperative instability, disc space narrowing, and segmental kyphosis. We report two cases of AECD that was performed 19 and 21 years ago. First case was a 44-year-old female with C56 cervical soft disc rupture and second case was a 42-year-old male with C67 cervical soft disc rupture. These patients suffered from cervical intervertebral disc herniation and underwent AECD. The surgical method followed the general AECD method that removed selectively-ruptured particle only. In both cases, the symptoms improved after AECD, and these patients did not experience any problems until recently. Good clinical results have been shown over the long-term, as seen in the two cases described here. In the radiological evaluation, it was confirmed that the postoperative level was stable and disc height was preserved. Furthermore, sagittal alignment and segmental motion of the cervical vertebra were both maintained. In these two cases, disc height was insignificantly different before and after surgery over a long period. Thus, AECD provides good results, even in long-term follow-up, without acceleration of disc degeneration.