• Lei Chu, Jun-Song Yang, Ke-Xiao Yu, Chien-Min Chen, Ding-Jun Hao, and Zhong-Liang Deng.
• Department of Orthopaedics, The Second Affiliated Hospital, Chongqing Medical University, District Yuzhong, Chongqing, China.
• World Neurosurg. 2018 Oct 1; 118: 102-108.

BackgroundCurrently, anterior transdiscal access and posterior interlaminar approach are the main approaches for percutaneous endoscopic cervical discectomy (PECD). To overcome access shortcomings, we previously described a novel anterior endoscopic transcorporeal approach on a migrated cervical disc. We innovatively introduced bone wax into endoscopic surgery to aid hemostasis and facilitate the process of drilling an intracorporeal tunnel.MethodsFive patients with cervical intervertebral disc herniation (CIDH) were treated by PECD via the anterior transcorporeal approach. During the operation, we marked the punctured tunnel with bone wax containing indigo carmine as a guide and smeared bone wax on the endoscopic burr to aid hemostasis.ResultsA satisfactory clinical outcome was observed in all 5 patients postoperatively; pain and neurologic condition were dramatically improved. Surgery-related complications, such as esophageal injury, vascular rupture, hematoma, intervertebral disc infection, or postoperative headache, were not encountered. A computed tomography scan was used to observe the process of bone healing. At 3-month postoperative follow-up, the bone defect within the drilling tunnel had partially shrank and was completely healed at 6 months postoperatively.ConclusionsThe anterior endoscopic transcorporeal approach for PECD is a novel, valuable alternative for the treatment of CIDH. Bone wax could indeed facilitate the operation by guiding the drilling process and instantly controlling the bleeding without obvious interference with bone healing. Long-term follow-up is warranted in further clinical studies.Copyright © 2018 Elsevier Inc. All rights reserved.

28 keywords...

hide…