Full-Endoscopic Procedures Versus Traditional Discectomy Surgery for Discectomy: A Systematic Review and Meta-analysis of Current Global Clinical Trials

[The first experience with a new technique of portal endoscopic discectomy for herniated cervical discs]

Choosing the most appropriate tactics for surgical treatment of herniated cervical discs is a topical issue to be discussed. The idea of herniated disc removal using an endoscopic technique is not new. This is routine surgery for the lumbar spine. However, application of endoscopic techniques in surgery on the cervical spine was first reported only in 2014 (J. Yang, et al.).

OBJECTIVE

To master the methodology of a new technique, portal endoscopic discectomy, and define the indications for this surgery on herniated cervical discs; to compare outcomes of this surgery with outcomes of anterior microsurgical discectomy.

MATERIAL AND METHODS

The study included 25 patients who underwent portal endoscopic cervical discectomy. A comparison group consisted of 25 patients who underwent anterior microsurgical discectomy and placement of an interbody cage.

RESULTS

A comparison of the results of surgeries revealed no significant difference (p>0.05) in the degree of postoperative local and radicular pain syndrome. According to the Neck Disability Index (NDI), a significant improvement occurred in patients with endoscopic surgery. According to the Odom criterion, a significant advantage in the number of excellent and good outcomes occurred in patients of the study group. There were significant differences between groups in the duration of postoperative hospital stay. The duration was 3 days in the study group and 5 days in the control group, on average.

CONCLUSION

Portal endoscopic discectomy is highly efficient in treatment of herniated cervical discs and enables achieving clinical outcomes associated with much less surgical trauma. The study demonstrates not only the efficacy of the suggested technique but also its safety compared to that of traditional anterior microsurgical techniques that usually involve interbody fusion. This surgery surpasses other interventions in the rate of rehabilitation and social adaptation of patients as well as reduces postoperative hospital stay.