Efficacy and safety of microendoscopic anterior cervical decompression and fusion. Compared with conventional open surgery.

Abstract

Retrospective observational study of consecutive patients. This study aimed to (1) develop a new surgical procedure using microendoscopy in anterior cervical decompression and fusion (ACDF), (2) compare the complications and postoperative courses in patients with the new microendoscopic and conventional ACDFs, and (3) confirm the efficacy and safety of the microendoscopic ACDF. ACDF is an excellent procedure that is minimally invasive to the muscle tissue and can improve alignment. However, it poses significant risks of complications such as postoperative acute airway obstruction. Retraction manipulation during surgery is considered the cause. Hence, we introduced microendoscopic surgery, which minimizes retraction manipulation. This study aimed to verify the safety and efficacy of microendoscopic ACDF. We compared the anteroposterior thickness of the prevertebral soft tissue on the radiographs preoperatively and 1, 2, and 7 days postoperatively in 15 patients who underwent conventional ACDF with 8 patients undergoing microendoscopic ACDF. Additionally, we assessed the perioperative complications and postoperative course. Microendoscopic ACDF significantly reduced prevertebral soft tissue swelling 2 and 7 days postoperatively. No significant differences in surgical data, complications, or rates of symptom improvement were found between the two groups. Microendoscopic ACDF reduces postoperative prevertebral soft tissue swelling. Surgical data and efficacy are comparable to those of conventional techniques, indicating the safety and effectiveness of the procedure.