Anterior Approach Using Transvertebral Discectomy for C2-C3 Disc Herniation: Case Report

C2-C3 disc herniation is an extremely rare condition, accounting for <1% of all cervical disc herniations. Discectomy using the posterior transdural or anterior transretropharyngeal approach has been used for its treatment. However, there are still concerns regarding the invasiveness and potential complications of these techniques. Herein, we report a case of C2-C3 disc herniation treated with transvertebral discectomy, assisted by an intraoperative navigation system. An 80-year-old woman presented with worsening numbness and pain in the left upper extremity, as well as gait instability. Magnetic resonance imaging revealed a left-dominant C2-C3 disc herniation compressing the spinal cord. As symptoms showed minimal improvement with conservative treatment, surgical intervention was performed. Through a 4-cm transverse incision on the left side of the neck and a 6-mm bone window, a transvertebral discectomy was performed to remove the C2-C3 disc herniation. An intraoperative navigation system was used to enhance surgical accuracy. The herniated disc fragment was successfully removed via the transvertebral approach without intraoperative complications. Intraoperative navigation helped ensure a safe and accurate surgical procedure. The patient's symptoms improved immediately, and she was discharged to home 1 week later. Transvertebral discectomy enables minimally invasive removal of C2-C3 disc herniation. Combined preoperative magnetic resonance imaging and intraoperative computed tomography using navigation system supports a safer and more comprehensive removal.