Endoscopic-assisted ACDF for C2-C3 disc herniation : a case report of successful decompression.

The C2-C3 segment presents unique surgical challenges due to its anatomical complexity. Traditional anterior cervical discectomy and fusion (ACDF) under microscopy often yields suboptimal visualization. We report the first successful application of full endoscopic-assisted ACDF for C2-C3 disc herniation with spinal cord compression. A 46-year-old male with refractory neck pain (VAS 8/10) underwent preoperative MRI/CT confirming severe C2-C3 herniation. Endoscopic-assisted ACDF via anterior approach achieved complete discectomy, and PEEK cage placement with fixation. Endoscopic visualization enhanced instrument maneuverability in the high cervical region while minimizing soft tissue disruption, reducing postoperative morbidity compared to conventional ACDF. This technique demonstrates feasibility as a minimally invasive alternative for C2-C3 pathologies, addressing limitations of microscopic approaches through improved illumination and angled viewing. The case underscores the importance of surgeon expertise in endoscopic spinal surgery and device selection tailored to narrow anatomical spaces. While short-term outcomes are promising, multicenter studies with long-term follow-up are needed to validate durability and complication profiles. This innovation expands minimally invasive options for high cervical spinal disorders.