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Minimally invasive posterior cervical foraminotomy versus anterior cervical discectomy and fusion for cervical radiculopathy: a meta-analysis

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Abstract

With the recent development of minimally invasive techniques, minimally invasive posterior cervical foraminotomy (MIS-PCF) has become increasingly popular as a minimally invasive method to treat cervical radiculopathy. However, there are still controversies about whether MIS-PCF is superior to anterior cervical discectomy and fusion (ACDF). The purpose of this study is to evaluate the therapeutic effects of MIS-PCF and ACDF on unilateral cervical radiculopathy without myelopathy. We searched PubMed, Embase, the Cochrane Library, and Scopus comprehensively using the terms related to MIS-PCF. Two reviewers independently evaluated the potential studies, and extracted and analyzed the data of operation time, hospital stay, neck disability index (NDI) score, visual analog scale for neck pain (VAS-neck) and arm pain (VAS-arm) scores, reoperation rate, and complications. Seven studies with 1175 patients were included. The study population was 53.5% male, with a mean age of 48.9. MIS-PCF presented a significantly shorter postoperative hospitalization time compared to ACDF, while the operation time, complication/reoperation rate, and VAS-arm, VAS-neck, and NDI scores were comparable between the two cohorts. In North America, the average cost of MIS-PCF is lower than ACDF. Thus, we suggest that MIS-PCF is an alternative to ACDF for selected patients.

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Funding

This study was funded by the Lvyang Jinfeng Talent Project of Yangzhou City (LYJF00027) and Jiangsu Innovative and Enterpreneurial Talent Programme (JSSCBS20211597).

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Authors and Affiliations

  1. Department of Orthopedics, Clinical Medical College of Yangzhou University, No. 98 Nantong West Road, Yangzhou, 225001, China

    Tao Zou, Ping-Chuan Wang, Hao Chen, Xin-Min Feng & Hui-Hui Sun

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  1. Tao Zou
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  2. Ping-Chuan Wang
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  3. Hao Chen
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  4. Xin-Min Feng
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Contributions

All authors contributed to the study conception and design. Literature retrieval, data collection, and analysis were performed by TZ, H-HS, P-CW, and HC. TZ, H-HS applied selection criteria, extracted data, and evaluated study quality. The first draft of the manuscript was written by TZ and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Xin-Min Feng or Hui-Hui Sun.

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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethical Committee of the Clinical Medical College of Yangzhou University. Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Zou, T., Wang, PC., Chen, H. et al. Minimally invasive posterior cervical foraminotomy versus anterior cervical discectomy and fusion for cervical radiculopathy: a meta-analysis. Neurosurg Rev 45, 3609–3618 (2022). https://doi.org/10.1007/s10143-022-01882-5

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