Percutaneous endoscopic cervical foraminotomy as a new treatment for cervical radiculopathy

Abstract

Background: Anterior cervical discectomy and fusion (ACDF) is the gold standard treatment for this cervical radiculopathy. Posterior endoscopic cervical foraminotomy (PECF), an effective alternative to ACDF, is becoming widely used by an increasing number of surgeons. However, comparisons of the clinical outcomes of ACDF and PECF remain poorly explored. The purpose of this study was to evaluate and compare visual analog scale (VAS)-arm scores, VAS-neck scores, neck disability index (NDI) scores, reoperation, and complications in PECF and ACDF. Materials and Methods: We comprehensively searched electronic databases or platforms, including PubMed, Web of Science, EMBASE, and the Cochrane Controlled Trial Center, using the PRISMA guidelines. The required information, including VAS-arm scores, VAS-neck scores, NDI scores, reoperation, and complications, was extracted from qualified studies and independently tested and compared by 2 researchers. The methodological index for nonrandomized studies was used to evaluate study quality. Results: Nine studies consisting of 230 males and 256 females were included. The mean age of the included patients was 49.6 years, and the mean follow-up time was 20.6 months. The VAS-arm scores were significantly higher, and VAS-neck scores and NDI scores of PECF showed greater improvement trends for PECF than ACDF. The complication proportion of patients with PECF was lower, while the proportion of reoperation was similar between PECF and ACDF. ACDF was the most common revision surgery. The most common complication of PECF was transient paresthesia. Conclusion: Compared with ACDF, PECF is safe and effective in patients with unilateral cervical radiculopathy without myelopathy, and PECF does not increase the probability of reoperation and complications.

Full-endoscopy with intraoperative O-arm navigation for cervicothoracic gas-containing hemorrhagic synovial cyst: A case report

“…As previous literature reports about the lumbar synovial cysts removal, the posterior endoscopic approach reduces the muscle denervation and decreases the risk of postoperative hematoma. It preserves the range of segmental motion and shortens the patient's recovery time [ 26 , 27 ]. We hope to transfer the above technical superiority to cervical spine surgery.…”

Fully endoscopic cervical spine surgery: What does the future hold?

“…Zhang et al .from the First Affiliated Hospital of University of South China, conducted a systematic review and meta-analysis of the studies done for percutaneous endoscopic cervical foraminotomy (PECF or FECF). 30 This was the only meta-analysis done specifically for endoscopic PCF and did not include other minimally invasive PCF approaches. It was interesting to note that in addition to indicating that VAS-arm scores were much better for PECF approach, the VAS-arm and NDI scores also showed a favorable trend over a median period of follow up of 20.9 months.…”

Minimally Invasive Full‐endoscopic Posterior Cervical Foraminotomy and Discectomy: Introducing a Simple and Useful Localization Technique of the “V” Point

“…It avoids excessive stripping of the posterior cervical muscle groups, reducing intraoperative bleeding, soft tissue injury and postoperative axial pain 19 . Several studies have demonstrated that full endoscopic cervical spine surgery is a safe, effective and promising alternative to conventional procedures on properly selected patients 20–22 …”

“…19 Several studies have demonstrated that full endoscopic cervical spine surgery is a safe, effective and promising alternative to conventional procedures on properly selected patients. [20][21][22] The "key-hole" technique is the basis of minimally invasive full endoscopic posterior cervical foraminotomy and discectomy (FPCD). And accurate localization of the "V" point (the intersection of the upper and lower lamina with the articular process)is a crucial step of the "key-hole" technique.…”