The Current State of Cervical Endoscopic Spine Surgery: an Updated Literature Review and Technical Considerations

Ahn, Yong

doi:10.1080/17434440.2020.1853523

Cited by 33 publications

(25 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Anterior cervical discectomy and fusion has turned into a standard procedure for cervical spondylotic radiculopathy because of its safety, effectiveness, and high fusion rate since the 1950s ( Ruetten et al, 2009 ; Yang et al, 2014 ; Ren et al, 2019 ), notwithstanding that it may cause some problems such as degeneration of adjacent segments, loss of intervertebral disc height, and pseudarthrosis formation ( Ruetten et al, 2009 ; Yang et al, 2014 ; Yuchi et al, 2019 ; Chen et al, 2020 ). With the development of full-endoscopic cervical discectomy, the complications of anterior cervical discectomy and fusion were managed appropriately ( Ruetten et al, 2009 ; Wu et al, 2018 ; Ahn, 2020 ). Full-endoscopic cervical discectomy is generally divided into two types, i.e., anterior transdiscal approach of endoscopic cervical discectomy (ATd-ECD) and posterior endoscopic cervical foraminotomy (PECF) ( Yang et al, 2014 ; Ren et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Comparative Analysis of the Biomechanical Characteristics After Different Minimally Invasive Surgeries for Cervical Spondylopathy: A Finite Element Analysis

Zhang

et al. 2021

Front. Bioeng. Biotechnol.

View full text Add to dashboard Cite

Minimally invasive surgeries, including posterior endoscopic cervical foraminotomy (PECF), microsurgical anterior cervical foraminotomy (MACF), anterior transdiscal approach of endoscopic cervical discectomy (ATd-ECD), and anterior transcorporeal approach of endoscopic cervical discectomy (ATc-ECD), have obtained positive results for cervical spondylotic radiculopathy. Nonetheless, there is a lack of comparison among them regarding their biomechanical performance. The purpose of this study is to investigate the biomechanical changes of operated and adjacent segments after minimally invasive surgeries compared to a normal cervical spine. A three-dimensional model of normal cervical vertebrae C3–C7 was established using finite element analysis. Afterwards, four surgical models (PECF, MACF, ATd-ECD, and ATc-ECD) were constructed on the basis of the normal model. Identical load conditions were applied to simulate flexion, extension, lateral bending, and axial rotation of the cervical spine. We calculated the range of motion (ROM), intradiscal pressure (IDP), annulus fibrosus pressure (AFP), uncovertebral joints contact pressure (CPRESS), and facet joints CPRESS under different motions. For all circumstances, ATc-ECD was close to the normal cervical spine model, whereas ATd-ECD significantly increased ROM and joints CPRESS and decreased IDP in the operated segment. PECF increased more the operated segment ROM than did the MACF, but the MACF obtained maximum IDP and AFP. Except for ATc-ECD, the other models increased joints CPRESS of the operated segment. For adjacent segments, ROM, IDP, and joints CPRESS showed a downward trend in all models. All models showed good biomechanical stability. With their combination biomechanics, safety, and conditions of application, PECF and ATc-ECD could be appropriate choices for cervical spondylotic radiculopathy.

show abstract

Section: Introductionmentioning

confidence: 99%

Comparative Analysis of the Biomechanical Characteristics After Different Minimally Invasive Surgeries for Cervical Spondylopathy: A Finite Element Analysis

Zhang

et al. 2021

Front. Bioeng. Biotechnol.

View full text Add to dashboard Cite

show abstract

“…[ 20 ] A recent review summarized the following 4 shortcomings: it is associated with technical challenges and is difficult to learn; there are relatively few practical indications, and the actual indications for endoscopic surgery may be limited to soft CDH or focal stenosis lesions; saline irrigation or hydraulic effects of unrecognized dural damage can occur during surgery; fluoroscopic guidance is required for several processes in the procedure. [ 21 ] All 4 disadvantages are consequential in terms of complex manipulation and delayed surgical time in a narrow surgical field. From the surgeon’s point of view, the limited degrees of freedom of the working device may be a practical hurdle in relation to these disadvantages.…”

Section: Discussionmentioning

confidence: 99%

Biportal endoscopic spine surgery for cervical disk herniation: A technical notes and preliminary report

Jung¹,

Kim

2022

Medicine

View full text Add to dashboard Cite

Biportal endoscopic spine surgery (BESS) for cervical disk herniation (CDH) has been rarely reported. The aim of the article is to describe a novel BESS as a posterior approach for CDH and report the preliminary outcomes and complications. This single-centered retrospective chart review included 109 consecutive patients who underwent BESS for symptomatic single-level CDH. Working and viewing portals were created in each unilateral paravertebral area at the target disk level. Endoscopic exploration allowed for effective and minimally invasive decompression via safe access to the medial foramen with minimal laminectomy and facetectomy. Clinical outcomes, including the visual analog scale, neck disability index, Macnab criteria, and the motor function of the involved arm, were evaluated at 4, 8, 12, and 24 postoperative weeks. Visual analog scale and neck disability index improved significantly at 24 weeks postoperatively (P < .01). According to the Macnab criteria, “excellent,” “good,” and “fair” results were obtained for 55.9%, 30.3%, and 13.8% of patients, respectively. The post 24-week distribution of the involved upper extremity strength grade was significantly improved compared to the initial value (P = .02). One patient had a motor weakness with a decreased grade over 4 weeks from excessive irrigation. The posterior approach of BESS was efficient and feasible for the treatment of CDH.

show abstract

“…Indications & Contraindications: The classical indication for FESS procedures in the cervical spine is focal cervical radiculopathy due to cervical disc herniation (CDH) or foraminal stenosis 27,166,169) . The indications have gradually expanded to include cervical spondylotic myelopathy and cervical stenosis as well 170,171) . But the studies have showed low reliability and doubtful results.…”

Section: Iii) Cervical Fessmentioning

confidence: 99%

“…Advances: Although calcified discs are difficult to address under the endoscope, a recent report of posterior transpedicular endoscopic access to calcified focal stenosis has reported good results 171) . Osseous stenosis was earlier a relative contraindication for full endoscopy, but few surgeons have reported good results with these too 170) .…”

Section: Iii) Cervical Fessmentioning

confidence: 99%

Expanded Indications of Full Endoscopic Spine Sugery

Krishnan

Kim

Raj

et al. 2021

J Minim Invasive Spine Surg Tech

View full text Add to dashboard Cite

Treatment of spine surgeries has evolved from traditional surgeries to open surgeries. Endoscopic spine surgeries (ESS) and endoscope assisted surgeries along with microscopic and tubular surgeries has developed significantly over the last three decades. With improvement in the diagnostic methods it is now possible to find and differentiate the spinal pathologies. ESS was initially limited to the lumbar disc herniations (DH). But, now it can be used for cervical and thoracic DH. Minimized technical problems has been brought by evolutions in endoscopy, better optics, instruments, access, and safety. Similarly acquired knowledge and skills are being extrapolated to advanced indications in different spinal pathologies. Due to the further advantages of ESS within the ambit of minimal invasive spine surgeries, many misnomers are as well getting added. This confuses the new learners and potential patients as well. ESS should be classified for uniformity in reporting and common nomenclature like FESS (Full endoscopic spine surgery) should be used. It specifically refers to surgery through one working channel under irrigation with incorporated optics. This will make easier understanding for novice surgeons and general population. It will lead to standardised reporting of high quality clinical studies, trials, and meta-analysis for the publications. Rising misnomers and complex nomenclature of endoscopy is suggesting along with the exponential publications in last decade that ESS is entering into its golden era. This review is undertaken to throw light on the techniques, advances and literature review of only FESS and clear the misnomers. This review also describes the evolution of different techniques and goals that led to impeccable advances in the field of FESS. Further improvement of technologies and techniques in future will soon establish FESS as the Gold Standard in spine surgery.

show abstract

The Current State of Cervical Endoscopic Spine Surgery: an Updated Literature Review and Technical Considerations

Cited by 33 publications

References 43 publications

Comparative Analysis of the Biomechanical Characteristics After Different Minimally Invasive Surgeries for Cervical Spondylopathy: A Finite Element Analysis

Comparative Analysis of the Biomechanical Characteristics After Different Minimally Invasive Surgeries for Cervical Spondylopathy: A Finite Element Analysis

Biportal endoscopic spine surgery for cervical disk herniation: A technical notes and preliminary report

Expanded Indications of Full Endoscopic Spine Sugery

Contact Info

Product

Resources

About