Current trends: Operative Strategy for the Management of Cervical Radiculopathy

Background: Endoscopic Cervical Discectomy has replaced many open fusion related surgery and bone grafting. Endoscopic surgery is without the placement of retractor and only need a working sheath diameter of about 7 mm incision, which is simple, easy to access with proper visualization. Minimal invasive surgery helped advancement in surgery by improvement in visualization. Depend on extend of lesion, type of compressive pathology curvature of the spine and presence of instability Surgeon choice the approaches. This newer approaches for radiculopathy help to decompress the neural elements and disc pathology preserving spinal motion and stability. It also helped to reduce the iatrogenic and for vertebral artery injuries. Methods: PubMed database, English literature, original articles, case reports, Operative technique reviewed. Focus articles related to the approaches of the cervical radiculopathy, current successful treatments replacing older open methods. Inclusion criteria pre-operative, post operative planning, Operative preparation, VAS score, intra -operative and endoscopic. Excluded criteria long term follow up data, bio-motion study in cadavers. Result: Degeneration of uncovertrebral and zygopophyseal joints lead to foraminal entrapment of spinal nerve roots and disc herniation. Preoperative history ,dynamic cervical extension-flexion, PET CT scan and MRI, Endoscopic Cervical Discectomy have replaced many open fusion related surgery and bone grafting .It works on placement of retractor, sheath diameter of about 7 mm incision which is easy access with proper visualization Fluoroscopic guided endoscopic surgery reduces iatrogenic tissue damage, postoperative pain , disability and return back to work early..Anterior approaches includes discectomy or corpectomy while posterior involves laminectomy with or without fusion and laminoplasty in spinal cord decompression. Open traditional surgical compared to newer minimal invasive surgery was much prolong hospital stay and delay healing. Conclusion: Proper visualization transform the spinal surgery reduces surgery related complication .Understanding surgical anatomy and reevaluation of cases helps to reduce vascular damage in anomaly position.