Anterior cervical discectomy and interbody fusion by endoscopic approach: a preliminary report.
OBJECTIVE
The authors report the short-term results of anterior cervical discectomy and interbody fusion performed via an endoscopic approach.


METHODS
Thirty-six patients who underwent anterior cervical discectomy and fusion (ACDF) performed using endoscopic surgery were selected for this study. The indications for surgery were cervical disc herniation caused by neck injury, spondylotic myelopathy, cervical radiculopathy, and solitary ossification of the posterior longitudinal ligament (OPLL). The involved levels included C3-4, C4-5, C5-6, and C6-7. The working channel was inserted through a 20-mm transverse incision, the protruding discs or area of OPLL were excised for complete decompression, and then an appropriate intervertebral polyetheretherketone fusion cage was implanted.


RESULTS
The time spent in surgery was 120 minutes on average (range 50-150 minutes), and the mean blood loss was 55 ml (range 20-140 ml). There were no intraoperative complications and no symptoms of irritation in the laryngopharynx after surgery. However, postoperative hemorrhage of the incision occurred in 1 case. The follow-up period ranged from 26-50 months (mean 38.5 months). Postoperative Japanese Orthopaedic Association and visual analog scale scores improved significantly.


CONCLUSIONS
Endoscopic surgery for ACDF can produce satisfactory results in patients with cervical disc herniation, cervical myelopathy, or radiculopathy. The optimal levels for this procedure are C4-5 and C5-6. Compared with a traditional approach, this technique has great advantages in terms of cosmetic results, intraoperative visualization, and postoperative recovery course. Nevertheless, every precaution should be taken to avoid possible complications, such as postoperative hemorrhage.
Tan
Jiangwei
J
Department of Orthopedic Surgery, Qilu Hospital, Shandong University, Jinan, Shandong, People's Republic of China.
Zheng
Yanping
Y
Gong
Liangtai
L
Liu
Xinyu
X
Li
Jianmin
J
Du
Wei
W
D000328:Adult; D000368:Aged; D001577:Benzophenones; D001672:Biocompatible Materials; D016063:Blood Loss, Surgical; D002574:Cervical Vertebrae / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods; D017586:Diskectomy / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery; D007659:Ketones; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000601:surgery; D017887:Ossification of Posterior Longitudinal Ligament / Q000601:surgery; D011092:Polyethylene Glycols; D011108:Polymers; D019106:Postoperative Hemorrhage / Q000209:etiology; D011843:Radiculopathy / Q000601:surgery; D013118:Spinal Cord Diseases / Q000601:surgery; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D013128:Spinal Osteophytosis / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome
D001577:Benzophenones; D001672:Biocompatible Materials; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols