PERCUTANEOUS CERVICAL DISKECTOMY - PRELIMINARY EXPERIENCE

We assessed the feasibility of percutaneous treatment of a cervical he rniated disc. In the lumbar region, the surgical instrument for percut aneous diskectomy passes only through the paravertebral muscles, while in the cervical region there is considerable risk of nervous, parench ymal and vascular lesions. Moreover, open surgery for cervical herniat ed nucleus pulposus is a well-established, low-risk procedure, with li ttle risk of epidural fibrosis, the main complication of lumbar open s urgery; a percutaneous procedure should there fore have a low morbidit y rate. A safe percutaneous approach to cervical discs could be useful for biopsy and for treatment of high-risk patients for general anaest hesia. We treated 15 patients with cervical herniated nucleus pulposus ; all gave informed consent and refused or were not eligible for open surgery. We used the Nucleotome(R) described for treatment of lumbar h erniated discs; except for the first three cases, we used colour Doppl er sonography to detect hazardous structures in the path of the probe. We had one complication, a cervical haematoma due to damage to the in ferior thyroid artery, prior to the use of ultrasound.