Endoscopic Laser Cervical Discectomy

This is the most advanced outpatient cervical spine procedure available in 2025 for treating a herniated or bulging cervical disc that is compressing a nerve root or pressing on the spinal cord.

It combines full-endoscopic visualization through a 6–8 mm incision with a precise side-firing holmium:YAG or thulium laser to:

- Shrink bulging disc material (decompression without removal) 

- Vaporize small herniated fragments 

- Reduce inflammation inside the disc and around the nerve 

- Perform virtually bloodless surgery 

You may be an excellent candidate if you have:

- Arm pain, numbness, or weakness that is clearly worse than neck pain (radiculopathy) 

- MRI showing a contained or small-to-medium herniation (foraminal or posterolateral) 

- Positive response to a selective nerve root block 

- Failed 6–12 weeks of conservative treatment (physical therapy, medications, injections) 

- No large free fragments, severe spondylosis, or spinal instability 

1. General anesthesia or conscious sedation with local anesthesia

2. You lie face-down; a 6-8 mm incision is made on the back of the neck

3. Under live X-ray guidance, a spinal needle is placed into the disc or foraminal zone

4. A 7-8 mm working cannula is inserted; the high-definition endoscope enters with continuous irrigation

5. The surgeon sees the herniated disc and compressed nerve in real time on a large monitor

6. Tiny graspers remove any loose fragments

7. The laser fiber is introduced:

      • Low-energy mode shrinks the bulging annulus

      • Higher energy vaporizes small fragments

      • Thermal effect reduces inflammation and calms the nerve

8. Decompression is confirmed when the nerve root pulsates freely

9. Instruments removed - usually closed with just a band-aid or one stitch

• Day of surgery: Home same day, mild neck stiffness

• Day 1-3: Over-the-counter pain medicine usually sufficient

• Day 3-10: 80-90% of arm pain gone; most patients return to office work

• Week 2: Resume driving and light exercise

• Week 4-6: Return to full activities, gym, and sports as tolerated

• Excellent or good arm pain relief: 90-96%

• Re-herniation at the same level: 2-6%

• Need for subsequent fusion: <2%

• Overall patient satisfaction: 94-97%

• Infection: <0.2%

• Dural leak: <1% (usually resolves without treatment)

• Temporary increased arm pain/numbness: 3-7% (resolves quickly)

• Transient hoarseness or swallowing discomfort: rare and short-lived

• Very rare serious complications: nerve injury, bleeding, vertebral artery injury

• Fever >101.5 °F (38.6 °C)

• New or worsening arm/hand weakness

• Difficulty swallowing or speaking

• Severe headache when standing up

• Redness, swelling, or drainage from the incision

Endoscopic laser cervical discectomy represents the pinnacle of motion-preserving, ultra-minimally invasive neck surgery in 2025.

If you suffer from arm pain caused by a herniated cervical disc, ask an experienced endoscopic spine surgeon whether you are a candidate for this revolutionary same-day procedure.

© 2025 - For patient education only. Individual results may vary. Always consult with your qualified spine surgeon.