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Back to the Future for Neck Surgery

Doctors in Germany have found a new way to do surgery on some neck problems. They use a tiny incision and a special device that gives them a 3-D (three-dimensional) view. This minimally invasive operation is done on the back (posterior) side of the neck. Disc degeneration and stenosis are the main problems treated with this surgical method.

Disc degeneration describes changes within the disc from wear, tear, and aging. Stenosis is a narrowing of the spinal canal, the opening through which the spinal cord passes. Bone spurs and a thickening of a nearby ligament can narrow the spinal canal. These are common changes with aging.

This new operation allows doctors to spare the muscles from damage. A small opening is made in the skin and tissue under the skin. The soft tissue on either side of the cut is spread apart gently. Then a special tool called a channel is inserted into the opening.

The channel comes in three lengths. It can be redirected and tilted to give the doctor a better view--all in 3-D. The neck muscles remain intact. This means that the patient doesn't need any type of neck support after the operation.

Neck movement can begin as early as four hours after the surgery. Early mobilization means fewer problems. In this study, four patients had total recovery from their symptoms after the operation. The other eight patients were better. They noted less pain and fewer neurological problems.

The authors report that this new approach gives the doctor a good view inside the neck. There is no damage to the muscles or nearby soft tissues. It only takes about an hour to operate on each segment. And only one suture is needed to close the opening.

The new minimally invasive approach to posterior cervical spine stenosis expands new options for surgeons who perform neck surgery. The authors of this report suggest that severe stenosis continue to be treated with the usual open incision.

References: H. Boehm, et al. A New Minimally Invasive Posterior Approach for the Treatment of Cervical Radiculopathy and Myelopathy: Surgical Technique and Preliminary Results. In European Spine Journal. June 2003. Vol. 12. No. 3. Pp. 268-273.

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