Minimizing Risks in Anterior Endoscopic Cervical Discectomy Using Ultrasound-Guided Hydrodissection: A Technical Report

Anterior endoscopic cervical discectomy (AECD) is a minimally invasive alternative to anterior cervical discectomy and fusion (ACDF) for treating cervical disc herniation. Despite its advantages, AECD poses risks to delicate anatomical structures, including the esophagus, recurrent laryngeal nerve, inferior thyroid artery, and carotid artery. This report introduces a novel ultrasound-guided hydrodissection technique designed to enhance the safety of AECD by improving visualization and reducing iatrogenic injury. By employing ultrasound imaging, key structures can be identified in real time, while hydrodissection creates a protective space, minimizing tissue trauma when advancing the needle. This technique allows precise needle placement and facilitates a safer surgical approach. The integration of ultrasound guidance with the hydrodissection technique has the potential to reduce complications and improve procedural accuracy, making it a valuable adjunct to AECD.