Arthroscopic Anterior Diskectomy of the Cervical Spine

Published:November 14, 2007DOI:


      We describe a minimally invasive arthroscopic technique for anterior diskectomy of the cervical spine. Fingertip pressure is applied between the carotid sheath laterally and the pharynx medially. The trachea and esophagus are displaced to the contralateral side. The disk level, soft-tissue thickness, and midline are verified with image intensification. A spinal needle is inserted through the soft tissue into the disk space at the midline. Contrast is injected to facilitate visualization. While maintaining displacement of the pharynx, a 4-mm vertical incision is made to incorporate the needle and is enlarged bluntly. A guidewire is passed through the needle. A dilator is passed over the guidewire, through the soft tissue, and usually into the disk, stopping posterior to the mid-vertebral body, as verified with lateral imaging. A cannula is placed over the dilator, and the dilator and wire are removed. Occasionally, the cannula is passed over the dilator to the anterior aspect of the disk, and the dilator is replaced with a trephine to penetrate the anterior spinal ligament, osteophytes, and annulus. The cannula seated in the middle of the disk allows diskectomy to commence with small rongeurs through the cannula, followed by a cervical spine arthroscope with a working channel. The arthroscope is removed, and further diskectomy is performed under fluoroscopic guidance with a motorized shaver and radiofrequency probe.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Cloward R.B.
        The anterior approach for removal of ruptured cervical discs.
        J Neurosurg. 1958; 15: 602-617
        • Whitecloud III, T.S.
        Degenerative disorders.
        in: The cervical spine. JB Lippincott, Philadelphia1989: 656
        • Bolesta M.J.
        • Gill K.
        Acute neck pain and cervical disc herniation.
        OKU Spine. 2006; 3: 228
        • Hankinson H.L.
        • Wilson C.B.
        Use of the operating microscope in anterior cervical discectomy without fusion.
        J Neurosurg. 1975; 43: 452-456
        • Cloward R.B.
        Cervical discography contribution to the etiology and mechanism of neck, shoulder and arm pain.
        Ann Surg. 1959; 150: 1051
        • Chiu J.C.
        • Clifford T.J.
        • Greenspan M.
        Percutaneous microdecompressive endoscopic cervical diskectomy with laser thermodiskoplasty.
        Mt Sinai J Med. 2000; 67: 278-282
        • Lee S.H.
        Comparison of percutaneous endoscopic discectomy to open anterior discectomy for cervical herniations.
        Internet J Minim Invasive Spinal Technol. 2001; : 17-19