Department of Neurosurgery, College of Medicine, Chosun University, Gwangju, Korea.
Department of Neurosurgery, College of Medicine, Chosun University, Gwangju, Korea.
World Neurosurg. 2023 Oct;178:330-339. doi: 10.1016/j.wneu.2023.07.058. Epub 2023 Jul 20.
There are no systematic evidence-based medical data on the complications of endoscopic cervical spinal surgery. This narrative analysis compiled data from various studies that examined endoscopic complications, such as cervical disc herniation and foraminal stenosis. This study aimed to investigate the efficacy and safety of endoscopic surgery in cervical radiculopathy.
We searched the PubMed/MEDLINE databases to identify articles on endoscopic spinal surgery, and keywords were set as "endoscopic cervical spinal surgery", "endoscopic cervical discectomy", "endoscopic cervical foraminotomy", and "percutaneous endoscopic cervical discectomy". We analyzed the evidence level and classified the prescribed complications according to the literature. Endoscopic cervical surgery was divided into three categories: full endoscopic anterior, endoscopic posterior, and unilateral biportal approaches. We excluded duplicate publications, studies without full text, studies without complications or incomplete information, and studies that did not provide the necessary data for extraction, animal experiments, or reviews.
Difficulties in swallowing, hematoma, and hoarseness are common complications associated with the anterior cervical approach. In contrast, complications of the posterior approach include nerve root injury, hematoma, and dysesthesia. However, endoscopic cervical spinal surgery, including the full endoscopic anterior, posterior, and unilateral biportal approaches, is a safe and effective treatment for cervical radiculopathy.
Complications of full endoscopic cervical spinal surgery differ significantly depending on the anterior and posterior approaches. In the anterior approach, swallowing difficulty, recurrent disc, hematoma, and dysphonia are the common complications. In contrast, transient dysesthesia, dural tears, upper limb motor deficits, and persistent arm pain are commonly reported with the posterior approach.
目前尚无关于内镜颈椎脊柱手术并发症的系统循证医学数据。本叙事分析综合了各种研究的资料，这些研究检查了内镜并发症，如颈椎间盘突出症和神经孔狭窄症。本研究旨在探讨内镜手术治疗颈椎神经根病的疗效和安全性。
我们在 PubMed/MEDLINE 数据库中搜索有关内镜脊柱手术的文章，关键词设定为“内镜颈椎脊柱手术”、“内镜颈椎间盘切除术”、“内镜颈椎侧路椎间孔切开术”和“经皮内镜颈椎间盘切除术”。我们分析了证据水平，并根据文献对规定的并发症进行了分类。内镜颈椎手术分为三种类型：全内镜前路、内镜后路和单侧双通道入路。我们排除了重复发表的文章、没有全文的研究、没有并发症或信息不完整的研究、以及没有提供必要数据提取的研究、动物实验或综述。
吞咽困难、血肿和声音嘶哑是颈前路常见的并发症。相比之下，后路的并发症包括神经根损伤、血肿和感觉异常。然而，内镜颈椎脊柱手术，包括全内镜前路、后路和单侧双通道入路，是治疗颈椎神经根病的一种安全有效的方法。
全内镜颈椎脊柱手术的并发症因前、后路而有显著差异。在前路，吞咽困难、复发性椎间盘突出、血肿和发音困难是常见的并发症。相比之下，后路常见的并发症包括短暂感觉异常、硬脑膜撕裂、上肢运动障碍和持续性手臂疼痛。
