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Dr Nitin Garg

Cervical Disc Prolapse

35 year old patient presented with right sided radiculopathy in upper limb. MRI showed a right sided cervical prolapsed disc with significant neural foramina compromise. After failure of conservative management, he was considered for surgery. Conventional surgical options include anterior approach, discectomy and fusion and dorsal foraminotomy.
A disc preserving approach -- anterior microforamonitomy (Jho's approach) was considered for this patient in view of unilateral disc causing radiculopathy.
In this surgical method, uncovertebral joint is drilled and only partial prolapsed disc is removed preserving the remaining disc (as seen in MRI images). Thus, this is a minimally invasive disc preserving surgery.
Aids used: Microscope, C-arm, Neurosurgical drill
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Figure 1a: T2W Sagittal showing tumor with significant cord compression
neurosurgeon in bhopal
Figure 1b: Axial MRI with right foraminal disc rolapse
neurosurgeon in bhopal
Figure 2a: Post op Sagittal MRI with decompressed root
neurosurgeon in bhopal
Figure 2b: Axial MRI showing the trajectory and decompressed root and foramina
Dr Nitin Garg