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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

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 radi...

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Autores principales: Guo, Linlin, Wang, Jiajing, Zhao, Zhen, Li, Jing, Zhao, Hongyang, Gao, Yong, Chen, Chao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9949523/
https://www.ncbi.nlm.nih.gov/pubmed/35344521
http://dx.doi.org/10.1097/BSD.0000000000001327
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author Guo, Linlin
Wang, Jiajing
Zhao, Zhen
Li, Jing
Zhao, Hongyang
Gao, Yong
Chen, Chao
author_facet Guo, Linlin
Wang, Jiajing
Zhao, Zhen
Li, Jing
Zhao, Hongyang
Gao, Yong
Chen, Chao
author_sort Guo, Linlin
collection PubMed
description 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.
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spelling pubmed-99495232023-02-24 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 Guo, Linlin Wang, Jiajing Zhao, Zhen Li, Jing Zhao, Hongyang Gao, Yong Chen, Chao Clin Spine Surg Systematic Reviews and Meta-Analyses 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. Lippincott Williams & Wilkins 2023-03 2022-03-29 /pmc/articles/PMC9949523/ /pubmed/35344521 http://dx.doi.org/10.1097/BSD.0000000000001327 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (https://creativecommons.org/licenses/by/4.0/) (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/)
spellingShingle Systematic Reviews and Meta-Analyses
Guo, Linlin
Wang, Jiajing
Zhao, Zhen
Li, Jing
Zhao, Hongyang
Gao, Yong
Chen, Chao
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Systematic Reviews and Meta-Analyses
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9949523/
https://www.ncbi.nlm.nih.gov/pubmed/35344521
http://dx.doi.org/10.1097/BSD.0000000000001327
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