Comparison of Percutaneous Endoscopic Cervical Keyhole Foraminotomy versus Microscopic Anterior Cervical Discectomy and Fusion for Single Level Unilateral Cervical Radiculopathy

Weihu Ma; Yujie Peng; Song Zhang; Yulong Wang; Kaifeng Gan; Xuchen Zhao; Dingli Xu

doi:10.2147/IJGM.S378837

Comparison of Percutaneous Endoscopic Cervical Keyhole Foraminotomy versus Microscopic Anterior Cervical Discectomy and Fusion for Single Level Unilateral Cervical Radiculopathy

Int J Gen Med. 2022 Aug 29:15:6897-6907. doi: 10.2147/IJGM.S378837. eCollection 2022.

Authors

Weihu Ma¹, Yujie Peng², Song Zhang², Yulong Wang², Kaifeng Gan³, Xuchen Zhao², Dingli Xu²

Affiliations

¹ Orthopedic Department, Ningbo No.6 Hospital, Zhejiang, Ningbo, People's Republic of China.
² Clinical Medical Department, Medical School of Ningbo University Zhejiang, Ningbo, People's Republic of China.
³ Orthopedic Department, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, People's Republic of China.

Abstract

Objective: To compare the clinical and radiological outcomes between microscopic anterior cervical discectomy and fusion (ACDF) and percutaneous endoscopic cervical keyhole foraminotomy (PECF) for single level unilateral cervical radiculopathy.

Methods: A total of 127 patients (59 in PECF VS 68 in ACDF) were enrolled in this study from April 2016 to May 2018 with a minimum follow-up of 2 years. Clinical data including baseline data, Neck Disability Index (NDI), and Visual Analogue Scale for neck and arm (VAS-n, VAS-a) were collected and compared. Radiological evaluation such as disc height, ROM of cervical, Cobb's angle of cervical and Cobb's angle of operated segment was measured by two experienced radiologists in twice.

Results: There was no significant difference between the two groups in the baseline data, and hospital stay was significantly decreased in PECF group than ACDF group (P < 0.001). PECF group did not yield superior better outcomes in NDI, VAS-a and VAS-n than ACDF group except at 1-month follow-up. As for radiological outcomes, PECF group has significantly better cervical motion, cervical angle and segmental angle than ADCF group at 12- and 24-month follow-up visit (P < 0.05); however, ACDF had shown better disc height restoration and maintenance than PECF (P < 0.05). More complications including surface hematoma and swallowing difficulty were occurred in ADCF group.

Conclusion: Percutaneous endoscopic cervical keyhole foraminotomy could be the alternative method for anterior cervical discectomy and fusion in selective cases. However, the indication should be fulfilled, more studies need to be conducted to further testify the efficacy of PECF.

Keywords: microscopic anterior cervical discectomy and fusion; percutaneous endoscope cervical keyhole foraminotomy; unilateral cervical radiculopathy.