The challenges of decompression surgeries performed in the cervical spine
for degenerative spinal disease are 1) the avoidance of injuries to vital structures, 2)
prevention of neurological deterioration, or deficit 3) preservation of cervical
segmental stability to avoid post-decompression kyphosis 4) adequate decompression
of neural structures. Endoscopic spine surgery optimizes two essential aspects of
minimally invasive spine surgery: optimal visualization and minimal soft tissue
damage. Despite using a small diameter endoscope, the proximity of exiting nerve root,
spinal cord, and pedicle to the intervertebral disc make posterior endoscopic cervical
foraminotomy and discectomy difficult. To remove the disc without significant neural
retraction, our technique of full endoscopic partial pediculotomy, partial vertebrotomy
posterior endoscopic cervical foraminotomy and discectomy (PECFD) allows the
creation of a subneural working space for the endoscopic equipment to reach the
prolapsed disc or hypertrophic uncovertebral joint. This chapter describes this
technique and its clinical pearls to perform PPPV PECFD safely and efficiently.
Keywords: Cervical radiculopathy, Degeneration, Full endoscopic partial
pediculotomy, Partial vertebrotomy technique.