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

• Published in: World neurosurgery 2023-07, Vol.175, p.142-150
• Main Authors: Chang, Chao-Jui, Liu, Yuan-Fu, Hsiao, Yu-Meng, Chang, Wei-Lun, Hsu, Che-Chia, Liu, Keng-Chang, Huang, Yi-Hung, Yeh, Ming-Long, Lin, Cheng-Li
• Format: Article
• Language: English
• Subjects: Cervical discectomy; Cervical myelopathy; Cervical spine endoscope; Cervical Vertebrae - surgery; Decompression, Surgical - methods; Endoscopic decompression; Full endoscopic surgery; Humans; Middle Aged; Quality of Life; Spinal Cord Diseases - complications; Spinal Cord Diseases - surgery; Spondylosis - complications; Spondylosis - surgery; Treatment Outcome
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2023.05.012

Cervical spondylotic myelopathy (CSM) may seriously affect quality of life. In the literature, there is scarce evidence of the pros and cons of full endoscopic spine surgery in the treatment of CSM. The main purpose of this study was to conduct a systematic review to elucidate the efficacy of full endoscopic spine surgery in the management of patients with CSM. This systematic review was conducted in accordance with the PRISMA guidelines. A systematic search of Web of Science, PubMed MEDLINE, Embase, and Cochrane Library was conducted from the database inception to February 1, 2023. The study included 183 patients and their age was 56.78 ± 7.87 years. The average surgical time calculated was 96.34 ± 33.58 minutes. Intraoperative blood loss ranged from a minimal amount to 51 mL. The average duration of hospital stay was 3.56 ± 1.6 days. The average span for follow-up was on an interval of 18.7 ± 6.76 months. Significant improvements were noted in all aspects of functional outcomes and image results after full endoscopic cervical spine surgery, with no major complications. The current study found that both anterior transcorporeal and posterior surgical approaches could be used for the treatment of CSM with a full endoscopic technique. Indications of full endoscopic cervical spine surgery for CSM included cervical disc herniation, central canal stenosis, calcified ligamentum flavum, and ossification of the posterior longitudinal ligament. Improved postoperative outcomes with acceptable surgical complications were noted in this systematic review.