Posterior Lateral Endoscopic Cervical Discectomy Through a Lateral Mass Approach in the Treatment of Cervical Spondylotic Radiculopathy

Mingxin Chen; Qingshuai Yu; Si Cheng; Tao Hu; Xin Wang; Bo Lei; Chaofan Qin; Qingyan Long; Zhongliang Deng; Zhengjian Yan

doi:10.1016/j.wneu.2024.03.024

Posterior Lateral Endoscopic Cervical Discectomy Through a Lateral Mass Approach in the Treatment of Cervical Spondylotic Radiculopathy

World Neurosurg. 2024 Mar 13:S1878-8750(24)00399-1. doi: 10.1016/j.wneu.2024.03.024. Online ahead of print.

Authors

Affiliations

¹ Department of Orthopedics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
² Department of Clinical Skills Training Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
³ Department of Orthopedics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China. Electronic address: yanzj@hospital.cqmu.edu.cn.

PMID: 38490445
DOI: 10.1016/j.wneu.2024.03.024

Abstract

Objective: The present study outlines the feasibility, safety, and short-term clinical outcomes of posterior lateral endoscopic cervical discectomy (PLECD) through a lateral mass approach for treating cervical spondylotic radiculopathy (CSR).

Methods: This single-center retrospective observational study involved 30 patients with single-level CSR who had failed conservative treatment and presented with clinical symptoms consistent with imaging findings undergoing PLECD via a lateral mass approach. Primary outcomes included the visual analog scale (VAS) for neck and arm pain, the Japanese Orthopedic Association (JOA) score, and the modified MacNab criteria. Radiographic follow-up consisted of static and dynamic cervical radiographs and computed tomographic scans.

Results: Thirty patients (13 men and 17 women; mean age 48.8 ± 11.9 years) underwent this procedure, and the mean operative time was 74.90 ± 13.52 minutes. Mean follow-up was 7.37 ± 2.17 months. The VAS scores for the neck and arm decreased significantly at the last follow-up (neck, 26.80 ± 4.75 to 9.87 ± 1.78; arm, 71.30 ± 8.48 to 14.73 ± 4.00) (P < 0.05). The JOA score also decreased from 13.47 ± 1.36 to 15.90 ± 0.92 at the last follow-up (P < 0.05). Twenty-nine patients demonstrated satisfactory outcomes based on the modified MacNab criteria at the last follow-up. All patients exhibited a positive clinical response, experiencing relief from symptoms. Postoperative computed tomography (CT) scans confirmed the complete removal of lesions.

Conclusions: PLECD through a lateral mass approach, as an alternative to conventional "keyhole" approaches, proves to be a novel and viable therapeutic option for CSR, demonstrating both high efficacy and safety.

Keywords: Cervical spondylotic radiculopathy; Full-endoscopic cervical discectomy; Spine surgery.