Yunus Aydın’s Cervical Contralateral Microdiscectomy with fat graft Technique and Key Points

Cervical disc herniation is a condition that occurs due to the cracking or leaking of discs in the cervical region of the spine. This condition often leads to symptoms such as severe pain, numbness, and weakness by exerting pressure on the nerve roots in the neck area. Advances in surgical techniques and expertise have made significant progress in the treatment of such conditions.

Preoperative Assessment in Cervical Disc Herniation:

When the diagnosis of cervical disc herniation is made, all stability tests commonly performed before conventional surgery are usually negative. However, postoperative results can become unstable depending on the technique used. Tears in specific areas of the annulus may not cause instability, even after iatrogenic joint addition.

Pre-Fusion Period and Simple Discectomy:

During the pre-fusion period, one of the commonly used treatment methods for cervical disc herniation is simple discectomy. Positive clinical outcomes achieved with this method have been effective in improving the quality of life for patients.

Surgical Technique and Advantages: Contralateral Approach:

The contralateral approach used in surgical intervention for cervical disc herniation effectively targets lateral and foraminal disc herniations. It is generally easier and has lower risks compared to the ipsilateral approach, as the risk of damaging the root in the blind area is minimal.

Technical Details and Advantages: Incision Site:

C-arm fluoroscopy performed by marking one level below the determined distance for surgical intervention is crucial for selecting appropriate skin. Platysma opening performed using a Zenker retractor allows for potential access to the tracheoesophageal structure.

Technical Tips: Longus Colli Muscle and Myofascial Structures:

Avoiding contact with the longus colli muscle prevents autonomic nerve damage and provides biomechanical support. The placement of the Zenker retractor without injuring the tracheoesophageal and vascular structures prevents the assistant from fatigue.

Surgical Technical Details:

• If there are no osteophytes, bone is not taken from the anterior edge of the vertebra.
• To avoid injuring cartilage plates, stay parallel to the distance and work to empty the disc without taking the cartilage.
• Micro disk punch and bayonet curette are crucial for ensuring safe clearance.
• The use of fat grafts can prevent postoperative fusion and accelerate early recovery for the patient.

These surgical approaches and techniques have been developed to provide effective and safe treatment for patients with cervical disc herniation.