Percutaneous endoscopic cervical discectomy: a technical review

Abstract

The treatment of cervical disc herniations has evolved in the last 2 decades. While the anterior cervical discectomy and fusion continues being the gold standard for the treatment of radicular pain triggered by cervical disc herniation, other surgical approaches have been developed. Percutaneous endoscopic cervical discectomy has demonstrated the ability to decompress the exiting nerve root and dural sac correctly and encouraging clinical outcomes has been reported in the literature. One of the most important advantages offered by the endoscopic technique is the capability to resolve the patient's symptoms without the need for interbody fusion. Also, a specific and selective decompression under continuous visualization with minimal surgery-related trauma can be achieved. There are two percutaneous endoscopic cervical discectomy approaches: anterior and posterior. The decision to perform each other depends on pathology site. However, the endoscopic technique requires previous surgical training, a steep learning curve, and proper patient selection. The development of new hardware such as endoscopes with better optics, lighting systems, and endoscopic surgical tools have allowed using endoscopic techniques in more complex cases. The objective of this review is the technical description of the anterior and posterior percutaneous endoscopic cervical discectomy.

Percutaneous Endoscopic Cervical Discectomy versus Anterior Cervical Discectomy and Fusion: A Comparative Cohort Study with a Five-Year Follow-Up

“…They concluded that full-endoscopic cervical discectomy is a sufficient and safe alternative in selected cases. However, most reviews of PECD have been narrative literature reviews or technical considerations that lack meta-analysis or systematic review [11,28,29]. High-quality RCTs and meta-analyses are required to assess the full relevance and reliability of PECD compared with the conventional ACDF.…”

Full-endoscopic decompression for thoracic ossification of ligamentum flavum: surgical techniques and clinical outcomes

“…In particular, a preoperative signal change ratio ≥1.54 and symptom duration >12 months were significant risk factors for a poor surgical outcome. [ 13 ] In this study, 7 out of 14 patients had ISI. The mean preoperative symptom duration was approximately 7 months.…”

“…Most of the follow-up times reported in the literature are more than 18 months. [ 1 , 13 , 14 ] In particular, the recovery of spinal cord function requires a longer process. Complications such as OLF progression and secondary kyphosis require long-term follow-up.…”

Design of a robot-assisted system for transforaminal percutaneous endoscopic lumbar surgeries: study protocol

“…Percutaneous endoscopic spinal surgeries for lumbar, cervical, and thoracic regions categorized according to the surgical approaches are as follows: transforaminal lumbar, interlaminar lumbar, anterior cervical, posterior cervical, posterior thoracic, and posterolateral thoracic [21,30]. Furthermore, the cervical region has many important anatomical structures such as the trachea, esophagus, carotid artery, and thyroid, and the complications could be serious, such as vascular injury, prevertebral hematoma, swallowing dysfunction, esophageal injury, and nerve injuries [31,32]. The surgeon needs the landing point to be as close to the target as possible, which makes the learning curve steeper.…”