AbstractAim: To describe the novel technique and study the results of Transosseous disc preserving cervical discectomy in patients with posterolateral disc herniation. Background: Traditional anterior cervical discectomy followed by fusion may be nonphysiological with significant fusionrelated complications and adjacent segment degeneration. The functional discectomy technique, which includes removal of only the disc fragments compressing the neural structures while preserving the rest of the disc, may restore the mobility of the involved motion segment. Materials and Methods: The study included 24 consecutive patients who presented with upper limb radiculopathy with or without neurological deficits due to single level posterolateral soft disc herniation between August 2006 and June 2009. The patients were aged between 2254 years. Approach to the herniated disc was through a 45 mm circular hole made in the inferior vertebral body with cephalad inclination. The lateral wall of the body was kept intact in all cases. All patients were assessed for clinical and radiological outcomes at regular intervals. Results: The mean followup duration was 19 months (634 months). Radiculopathy symptoms improved in all the patients with mean VAS score reducing from 4.5 to 2.1 following surgery. None had worsening of axial neck pain. There was loss of disc height from mean of 5.8 mm to 5.4 mm and segmental sagittal lordosis from mean of 2.3 to 2.1.The segmental mobility decreased from mean of 4.1 preoperatively to 3.7 at last follow up. Two patients had intraoperative complications. No late complications reported so far. Conclusion: Transosseous discectomy gives satisfactory pain relief with adequate neural decompression in the studied group of patients with preservation of mobility. Long term follow up is needed to assess the mobility and its role in preserving the adjacent segment degeneration.
Keywords: Cervical Disc Prolapse; Transosseous Discectomy; Radicuopathy.