Full Endoscopic Spine Surgery for Cervical Spondylotic Myelopathy: A Systematic Review

Chao-Jui Chang; Yuan-Fu Liu; Yu-Meng Hsiao; Wei-Lun Chang; Che-Chia Hsu; Keng-Chang Liu; Yi-Hung Huang; Ming-Long Yeh; Cheng-Li Lin

doi:10.1016/j.wneu.2023.05.012

Full Endoscopic Spine Surgery for Cervical Spondylotic Myelopathy: A Systematic Review

World Neurosurg. 2023 Jul:175:142-150. doi: 10.1016/j.wneu.2023.05.012. Epub 2023 May 9.

Authors

Chao-Jui Chang¹, Yuan-Fu Liu², Yu-Meng Hsiao³, Wei-Lun Chang², Che-Chia Hsu⁴, Keng-Chang Liu⁵, Yi-Hung Huang⁶, Ming-Long Yeh⁷, Cheng-Li Lin⁸

Affiliations

¹ Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; Department of Orthopedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Skeleton Materials and Bio-compatibility Core Lab, Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Orthopaedics, Dou-Liou Branch of National Cheng Kung University Hospital, Yunlin, Taiwan.
² Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; Department of Orthopedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Orthopaedics, Dou-Liou Branch of National Cheng Kung University Hospital, Yunlin, Taiwan.
³ Department of Orthopedics, Tainan Municipal An-Nan Hospital, China Medical University, Tainan, Taiwan.
⁴ Department of Orthopedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁵ School of Medicine, Tzu Chi University, Hualien City, Taiwan; Department of Orthopaedic Surgery, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan.
⁶ Department of Orthopedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Orthopaedics, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City, Taiwan.
⁷ Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; Medical Device Innovation Center (MDIC), National Cheng Kung University Hospital, Tainan, Taiwan.
⁸ Department of Orthopedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Skeleton Materials and Bio-compatibility Core Lab, Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Medical Device Innovation Center (MDIC), National Cheng Kung University Hospital, Tainan, Taiwan; Musculoskeletal Research Center, Innovation Headquarter, National Cheng Kung University, Tainan, Taiwan. Electronic address: jengli94@gmail.com.

PMID: 37169077
DOI: 10.1016/j.wneu.2023.05.012

Abstract

Background: Cervical spondylotic myelopathy (CSM) may seriously affect quality of life. In the literature, there is scarce evidence of the pros and cons of full endoscopic spine surgery in the treatment of CSM. The main purpose of this study was to conduct a systematic review to elucidate the efficacy of full endoscopic spine surgery in the management of patients with CSM.

Methods: This systematic review was conducted in accordance with the PRISMA guidelines. A systematic search of Web of Science, PubMed MEDLINE, Embase, and Cochrane Library was conducted from the database inception to February 1, 2023.

Results: The study included 183 patients and their age was 56.78 ± 7.87 years. The average surgical time calculated was 96.34 ± 33.58 minutes. Intraoperative blood loss ranged from a minimal amount to 51 mL. The average duration of hospital stay was 3.56 ± 1.6 days. The average span for follow-up was on an interval of 18.7 ± 6.76 months. Significant improvements were noted in all aspects of functional outcomes and image results after full endoscopic cervical spine surgery, with no major complications.

Conclusions: The current study found that both anterior transcorporeal and posterior surgical approaches could be used for the treatment of CSM with a full endoscopic technique. Indications of full endoscopic cervical spine surgery for CSM included cervical disc herniation, central canal stenosis, calcified ligamentum flavum, and ossification of the posterior longitudinal ligament. Improved postoperative outcomes with acceptable surgical complications were noted in this systematic review.

Keywords: Cervical discectomy; Cervical myelopathy; Cervical spine endoscope; Endoscopic decompression; Full endoscopic surgery.

Publication types

Systematic Review
Review

MeSH terms

Cervical Vertebrae / surgery
Decompression, Surgical / methods
Humans
Middle Aged
Quality of Life
Spinal Cord Diseases* / complications
Spinal Cord Diseases* / surgery
Spondylosis* / complications
Spondylosis* / surgery
Treatment Outcome