Skip to main content

Full-endoscopic technique for anterior cervical discectomy and interbody fusion: 5-year follow-up results of 67 cases

European Spine Journal volume 20, pages 899–904 (2011)Cite this article

Abstract

With minimally invasive technique becoming more popular, endoscopic operations such as arthroscopy or laparoscopy have become the standard of care in several other areas. In this study, we evaluated the 5-year follow-up outcomes of anterior cervical (Ahn et al. in Photomed Laser Surg 23:362–368, 2005) discectomy and interbody fusion (ACDF) performed via endoscopic approach. Sixty-seven patients who underwent anterior cervical discectomy and cage fusion performed using endoscopic technique were followed for at least 5 years. We reviewed the clinical and radiographic records of these patients. The postoperative radiographic measures accessed were the anterior intervertebral height (AIH) and the lordosis angle (LDA). Clinical outcomes were determined using the previously validated Japanese Orthopaedic Association (JOA) and the pain visual analog scale (VAS). Patients included had a minimal follow-up period of 5 years and based on the outcomes criteria (JOA, VAS), 86.6% of patients reported excellent or good results. The AIH increased on average 18.7% of the original height (p < 0.01), and the LDA were more physiologic at final follow-up. Of the 67 cases, there was no segmental instability, and the bone fusion rate was 100%. One patient required revision open ACDF due to adjacent segment disc herniation 6 years postoperatively. There were no intraoperative complications, dysphasia or esophageal injury in this study group. It indicated endoscopic technique for ACDF can obtain satisfactory results in patients with cervical disc herniation, cervical myelopathy, or radiculopathy. Compared with a traditional approach, this technique may be associated with less morbidity while improving cosmesis and postoperative recovery. Prospective randomized control trials are needed to directly compare these two procedures.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3

References

  1. Ahn Y, Lee S, Shin S (2005) Percutaneous endoscopic cervical discectomy: clinical outcome and radiographic changes. Photomed Laser Surg 23:362–368

    PubMed  Article  Google Scholar 

  2. Baba H, Furusawa N, Tanaka Y, Wada M, Imura S, Tomita K (1994) Anterior decompression and fusion for cervical myeloradiculopathy secondary to ossification of the posterior ligament. Int Orthop 18:204–209

    PubMed  CAS  Google Scholar 

  3. Bomback DA, Charles G, Widmann R, Boachie A (2007) Video-assisted thoracoscopic surgery compared with thoracotomy: early and late follow-up of radiographical and functional outcome. Spine J 7:399–405

    PubMed  Article  Google Scholar 

  4. Brooke NS, Rorke AW, King AT, Gullan RW (1997) Preliminary experience of carbon fiber cage prostheses for treatment of cervical spine disorders. Br J Neurosurg 11:221–227

    PubMed  Article  CAS  Google Scholar 

  5. Castro FP Jr, Holt RT, Majd M, Whitecloud TS (2000) A cost analysis of two anterior cervical fusion procedures. J Spinal Disord 13:511–514

    PubMed  Article  Google Scholar 

  6. Ditsworth DA (1998) Endoscopic transforaminal lumbar discectomy and reconfiguration: a postero-lateral approach into the spinal canal. Surg Neurol 49:588–598

    PubMed  Article  CAS  Google Scholar 

  7. Dowd GC, Wirth FP (1999) Anterior cervical discectomy is fusion necessary? J Neurosurg 90(Suppl 1):8–12

    PubMed  CAS  Google Scholar 

  8. Fontanella A (1999) Endoscopic microsurgery in herniated cervical discs. Neurol Res 21:31–38

    PubMed  CAS  Google Scholar 

  9. Fraser JF, Hartl R (2007) Anterior approaches to fusion of the cervical spine: a metaanalysis of fusion rates. J Neurosurg Spine 6:298–303

    PubMed  Article  Google Scholar 

  10. Ghogawala Z, Coumans JV, Benzel EC, Stabile LM, Barker FG (2007) Ventral versus dorsal decompression for cervical spondylotic myelopathy: surgeons’ assessment of eligibility for randomization in a proposed randomized controlled trial: results of a survey of the Cervical Spine Research Society. Spine 32:429–436

    PubMed  Article  Google Scholar 

  11. Goto S, Mochizuki M, Watanabe T, Hiramatu K, Tanno T, Kitahara H et al (1993) Long-term follow-up study of anterior surgery for cervical spondylotic myelopathy with special reference to magnetic imaging findings in 52 cases. Clin Orthop 291:142–153

    PubMed  Google Scholar 

  12. Kambin P, Schaffer J (1998) Percutaneous Lumbar discectomy. Review of 100 patients and current practice. Clin Orthop 238:24–34

    Google Scholar 

  13. Lew SM, Mehalic TF, Fagone KL (2001) Transforaminal percutaneous endoscopic discectomy in the treatment of far-lateral and foraminal lumbar disc herniations. J Neurosurg 94:216–220

    PubMed  CAS  Google Scholar 

  14. Majd ME, Vadhva M, Holt RT (1999) Anterior cervical reconstruction using titanium cages with anterior plating. Spine 24:1604–1610

    PubMed  Article  CAS  Google Scholar 

  15. Ono K, Ebara S, Fuji T, Yonenobu K, Fujiwara K, Yamashita K (1987) Myelopathy hand. New clinical signs of cervical cord damage. J Bone Joint Surg Br 69:215–219

    PubMed  CAS  Google Scholar 

  16. Park HW, Lee JK, Moon SJ (2009) The efficacy of the synthetic interbody cage and grafton for anterior cervical fusion. Spine 34:E591–E595

    PubMed  Article  Google Scholar 

  17. Raj DR, Krishnaj G, Kenny S (2006) Operative treatment of cervical spondylotic myelopathy. J Bone Joint Surg Am 88:1619–1640

    Article  Google Scholar 

  18. Rao RD, Gourab K, David KS (2006) Operative treatment of cervical spondylotic myelopathy. J Bone Surg Am 88:1619–1640

    PubMed  Article  Google Scholar 

  19. Savolainen S, Rinne J, Hernesniemi J (1998) A prospective randomized study of anterior single-level cervical disc operations with long-term follow-up: surgical fusion is unnecessary. Neurosurgery 43:51–55

    PubMed  Article  CAS  Google Scholar 

  20. Silber JS, Anderson DG, Daffner SD, Brislin BT, Leland JM, Hilibrand AS et al (2003) Donor site morbidity after anterior iliac crest bone harvest for single-level anterior cervical discectomy and fusion. Spine 28:134–139

    PubMed  Article  Google Scholar 

  21. Suri A, Chabbra RP, Mehta VS, Gaikwad S, Pandey RM (2003) Effect of intramedullary signal changes on the surgical outcome of patients with cervical spondylotic myelopathy. Spine J 3:33–45

    PubMed  Article  Google Scholar 

  22. Yeung AT, Tsou PM (2002) Posterolateral endoscopic excision for lumbar disc herniation. surgical technique, outcome, and complications in 307 consecutive cases. Spine 27:722–731

    PubMed  Article  Google Scholar 

Download references

Acknowledgments

We thank the education department of Hunan province for providing the grant.

Conflict of interest

None of the authors has any potential conflict of interest.

Author information

Affiliations

  1. Department of Spinal Surgery, 1st Affiliated Hospital, University of South China, Hengyang, 412001, Hunan, People’s Republic of China

    Nuzhao Yao, Cheng Wang, Wenjun Wang & Lushan Wang

Authors
  1. Nuzhao Yao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cheng Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wenjun Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lushan Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lushan Wang.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Yao, N., Wang, C., Wang, W. et al. Full-endoscopic technique for anterior cervical discectomy and interbody fusion: 5-year follow-up results of 67 cases. Eur Spine J 20, 899–904 (2011). https://doi.org/10.1007/s00586-010-1642-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-010-1642-0

Keywords

  • Cervical spine
  • Interbody fusion
  • Discectomy
  • Endoscopic microsurgery
  • Cage