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Weihu Ma,1 Yujie Peng,2 Song Zhang,2 Yulong Wang,2 Kaifeng Gan,3 Xuchen Zhao,2 Dingli Xu2 1Orthopedic Department, Ningbo No.6 Hospital, Zhejiang, Ningbo, Peopleâs Republic of China; 2Clinical Medical Department, Medical School of Ningbo University Zhejiang, Ningbo, Peopleâs Republic of China; 3Orthopedic Department, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Peopleâs Republic of ChinaCorrespondence: Dingli Xu, Email xudingliwo@126.comObjective: To compare the clinical and radiological outcomes between microscopic anterior cervical discectomy and fusion (ACDF) and percutaneous endoscopic cervical keyhole foraminotomy (PECF) for single level unilateral cervical radiculopathy.Methods: A total of 127 patients (59 in PECF VS 68 in ACDF) were enrolled in this study from April 2016 to May 2018 with a minimum follow-up of 2 years. Clinical data including baseline data, Neck Disability Index (NDI), and Visual Analogue Scale for neck and arm (VAS-n, VAS-a) were collected and compared. Radiological evaluation such as disc height, ROM of cervical, Cobbâs angle of cervical and Cobbâs angle of operated segment was measured by two experienced radiologists in twice.Results: There was no significant difference between the two groups in the baseline data, and hospital stay was significantly decreased in PECF group than ACDF group (P < 0.001). PECF group did not yield superior better outcomes in NDI, VAS-a and VAS-n than ACDF group except at 1-month follow-up. As for radiological outcomes, PECF group has significantly better cervical motion, cervical angle and segmental angle than ADCF group at 12- and 24-month follow-up visit (P < 0.05); however, ACDF had shown better disc height restoration and maintenance than PECF (P < 0.05). More complications including surface hematoma and swallowing difficulty were occurred in ADCF group.Conclusion: Percutaneous endoscopic cervical keyhole foraminotomy could be the alternative method for anterior cervical discectomy and fusion in selective cases. However, the indication should be fulfilled, more studies need to be conducted to further testify the efficacy of PECF.Keywords: unilateral cervical radiculopathy, percutaneous endoscope cervical keyhole foraminotomy, microscopic anterior cervical discectomy and fusion |
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