Full-endoscopic posterior cervical foraminotomy and discectomy for cervical disc hernia with unilateral radiculopathy

Abstract

Uniportal full-endoscopic posterior cervical foraminotomy and discectomy (PECF/D) has emerged as a promising minimally invasive technique for treating cervical radiculopathy caused by soft foraminal disc herniations. We report the case of a 42-year-old woman who presented with persistent neck and right arm pain unresponsive to conservative treatment. Neurological examination revealed weakness in wrist extension and hypoesthesia in the C6 dermatome. Magnetic resonance imaging demonstrated a right-sided C5–6 soft disc herniation compressing the C6 nerve root. Given the absence of bony stenosis and the foraminal location of the herniation, PECF/D was selected to achieve neural decompression while preserving cervical motion. The procedure was performed under general anesthesia with the patient in the prone position. A 1-cm incision was made, and a working cannula was introduced via a uniportal approach. Under continuous endoscopic visualization, a keyhole foraminotomy was performed with partial undercutting of the facet joint, and the herniated disc material was removed with minimal manipulation of the nerve root. The total operative time was 45 minutes, and no intraoperative complications occurred. The patient experienced immediate postoperative relief of radicular symptoms and was discharged the following day without neurological deficits. This case demonstrates the technical feasibility, safety, and efficacy of uniportal PECF/D in appropriately selected patients. The technique provides targeted decompression with minimal tissue disruption, avoids fusion, and preserves segmental motion, potentially reducing the risk of adjacent segment disease. As endoscopic spine surgery continues to advance, PECF/D represents a valuable alternative to anterior cervical approaches for soft, foraminal disc herniations.