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

Surgical Technique of Central and Over-the-Top Full-Endoscopic Decompression of the Cervical Spine: A Technical Note

“…The evolution from posterior open cervical foraminotomy to tubular, microendoscopic, and FESS, is associated with advantages, such as less surgical muscle aggression, a smaller incision, shorter hospital stay, less postoperative pain, and a shorter rehabilitation time [43], as traditional open cervical laminectomy is correlated with the possibility of instability and delayed kyphosis [40,[44][45][46]. Another advantage of full-endoscopic cervical spine surgery is the continuous saline irrigation, which can lead to the reduction of inflammatory agents and thus less intraoperative bleeding, resulting in a lower risk of dural tears due to the clear surgical field [47,48]. Although biomechanical and clinical studies comparing these techniques to traditional open techniques in terms of long-term outcomes have not been performed, reports in the literature from other segments of the spine suggest that the risk of infection after decompressions, length of hospital stay, risk of kyphosis increase, secondary need for fusion, and postoperative narcotic dependence is reduced [40].…”

“…Initially it was used for disc herniation and foraminal stenosis, but the development of the technique allows for its use in cases of cervical spondylotic myelopathy, including central canal stenosis, cervical disc herniation and calcified ligamentum flavum. Therefore, there is a significant improvement in all aspects of pain relief, imaging results, and functional outcomes, during midterm follow-up after full-endoscopic cervical spine surgery [48]. Anterior cervical discectomy and fusion has long been considered the gold standard for the treatment of cervical myelopathy or radiculopathy [48][49][50], however, the anterior approach can lead to serious complications such as injury to the esophagus, trachea, and neurovascular bundle during the procedure [48].…”

“…Therefore, there is a significant improvement in all aspects of pain relief, imaging results, and functional outcomes, during midterm follow-up after full-endoscopic cervical spine surgery [48]. Anterior cervical discectomy and fusion has long been considered the gold standard for the treatment of cervical myelopathy or radiculopathy [48][49][50], however, the anterior approach can lead to serious complications such as injury to the esophagus, trachea, and neurovascular bundle during the procedure [48]. Full-endoscopic anterior cervical discectomy is indicated when a herniated disc is unresponsive to conservative treatment and there is an annular tear with consistent pain on provocative discography.…”

“…Full-endoscopic anterior cervical discectomy is indicated when a herniated disc is unresponsive to conservative treatment and there is an annular tear with consistent pain on provocative discography. [48,51,52]. In contrast, migrated disc herniation, a collapsed disc space < 5 mm, calcified disc, infection, instability, and previous anterior cervical surgery are contraindications.…”

Anterior Full‐endoscopic Single‐port Double Transcorporeal Spinal Cord Decompression for Noncontinuous Two‐segment Cervical Spondylotic Myelopathy: A Technical Note

“… 19 After reviewing the literature, to date, no studies have described the use of anterior total endoscopic techniques in cases of two‐segment spinal cervical spondylosis. 20 In this study, we have the following objectives: (i) to propose a new technique, anterior full‐endoscopic single‐port double transcorporeal spinal cord decompression, and to present its technical features and details (Figure 1 ); and (ii) to report our short‐term clinical and radiographic results in order to assess its efficacy and safety in noncontinuous two‐segment CSM.…”