The Significance of Lumbar Probing Combined with Continuous Irrigation and Undercutting Posterior Vertebral Body for Highly Upward Migrated Disc Herniation in ACDF: Case Reports and technical notes

The purpose of this report was to present successful cases and technical notes of the patients with up migrated cervical disc herniation to the upper level who were successfully treated using anterior cervical discectomy and fusion (ACDF), describing the evaluation of treatment outcomes and perioperative complications. The cases of two patients who had ACDF in symptomatic up migrated cervical disc herniation to the upper level in February 2021 and November 2021 were reviewed. Two patients presented with a six-week history of posterior neck pain and radiating pain. Preoperative magnetic resonance imaging (MRI) confirmed a diagnosis of up migrated cervical disc extrusion. The patients were admitted to Daegu Wooridul Spine Hospital in Daegu, Korea. ACDF was performed under general anesthesia. Treatment outcomes were examined by comparing pre and postoperative Numeric Rating Scale (NRS), and MRI. Treatment outcomes were favorable: posterior neck pain and radiating pain showed a significant reduction in NRS. Postoperative MRI showed that the up migrated discs were successfully removed in both cases. Neither patient developed perioperative complications. Anterior cervical discectomy can be feasible in patients with symptomatic up migrated cervical disc herniation to the upper level.