Microscopic Anterior Cervical Discectomy and Fusion Versus Posterior Percutaneous Endoscopic Cervical Keyhole Foraminotomy for Single-level Unilateral Cervical Radiculopathy A Systematic Review and Meta-analysis

被引：13

作者：

Guo, Linlin ^{[1
]}

Wang, Jiajing ^{[2
]}

Zhao, Zhen ^{[2
]}

Li, Jing ^{[3
]}

Zhao, Hongyang ^{[2
]}

Gao, Yong ^{[4
]}

Chen, Chao ^{[4
,5
,6
]}

机构：

[1] Union Hosp, Dept Plast Surg, Terre Haute, IN USA

[2] Union Hosp, Dept Neurosurg, Terre Haute, IN USA

[3] Tongji Hosp, Dept Integrated Tradit Chinese & Western Med, Shanghai, Peoples R China

[4] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Orthopaed, Wuhan, Peoples R China

[5] Hefeng Cent Hosp, Dept Orthopaed, Enshi, Hubei, Peoples R China

[6] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Orthopaed, 1277 Jiefang Ave, Wuhan 430022, Hubei, Peoples R China

来源：

CLINICAL SPINE SURGERY | 2023年 / 36卷 / 02期

基金：

中国国家自然科学基金;

关键词：

meta-analysis; cervical radiculopathy; anterior cervical discectomy and fusion; keyhole; microscopic; endoscopic; INTERVERTEBRAL DISC; SAGITTAL ALIGNMENT; LUMBAR DISKECTOMY; FOLLOW-UP; DISEASE; MICRODISCECTOMY; EXPERIENCE; HERNIATION; HEIGHT; SPINE;

D O I：

10.1097/BSD.0000000000001327

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Study Design:A systematic review and meta-analysis. Objective:The objective of this study was to compare the safety of microscopic anterior cervical discectomy and fusion (MI-ACDF) and posterior percutaneous endoscopic keyhole foraminotomy (PPEKF) in patients diagnosed with single-level unilateral cervical radiculopathy. Summary of Background Data:After conservative treatment, the symptoms will be relieved in about 90% of cervical radiculopathy patients. For the other one tenth of patients, surgical treatment is needed. The overall complication rate of MI-ACDF and PPEKF ranges from 0% to 25%, and the reoperation rate ranges from 0% to 20%. Materials and Methods:Electronic retrieval of studies from PubMed, Embase, and Cochrane Library was performed to identify comparative or single-arm studies on MI-ACDF and PPEKF. A total of 24 studies were included in our meta-analysis by screening according to the inclusion and exclusion criteria. After data extraction and quality assessment of the included studies, a meta-analysis was performed by using the R software. The pooled incidences of efficient rate, total complication rate, and reoperation rate were calculated. Results:A total of 24 studies with 1345 patients (MI-ACDF: 644, PPEKF: 701) were identified. There was no significantly statistical difference in pooled patient effective rate (MI-ACDF: 94.3% vs. PPEKF: 93.3%, P=0.625), total complication rate (MI-ACDF: 7.1% vs. PPEKF: 4.7%, P=0.198), and reoperation rate (MI-ACDF: 1.8% vs. PPEKF: 1.1%, P=0.312). However, the common complications of the 2 procedures were different. The most common complications of MI-ACDF were dysphagia and vertebral body sinking, whereas the most common complication of PPEKF was nerve root palsy. Conclusions:Both MI-ACDF and PPEKF can provide a relatively safe and reliable treatment for single-level unilateral cervical radiculopathy. The 2 techniques are not significantly different in terms of effective rate, total complication rate, and reoperation rate.

引用

页码：59 / 69

页数：11

共 49 条

[1]

Ahn SS, 2016, WORLD NEUROSURG, V86, P250, DOI [10.1016/J.WNEU.2015.09.047, 10.1016/j.wneu.2015.09.047]

[2] Percutaneous endoscopic lumbar discectomy for recurrent disc herniation: Surgical technique, outcome, and prognostic factors of 43 consecutive cases [J].