Short-term clinical outcomes and technical advantages of mini-open endoscope assisted anterior cervical discectomy and fusion in the treatment of cervical spondylotic myelopathy

Abstract Background Although anterior cervical discectomy and fusion (ACDF) is the gold standard for treating cervical spondylotic myelopathy (CSM), it still has several disadvantages in spite the used of microscope. Unilateral biportal endoscopy is a newly developed minimally invasive spine surgery...

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Main Authors: Hua-zhang Zhong, Li Cheng, Qi-fei Wang, Bin Zhu, Lei Chen, Jue-hua Jing, Da-sheng Tian, Yun Zhou
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Musculoskeletal Disorders
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Online Access:https://doi.org/10.1186/s12891-025-08606-y
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author Hua-zhang Zhong
Li Cheng
Qi-fei Wang
Bin Zhu
Lei Chen
Jue-hua Jing
Da-sheng Tian
Yun Zhou
author_facet Hua-zhang Zhong
Li Cheng
Qi-fei Wang
Bin Zhu
Lei Chen
Jue-hua Jing
Da-sheng Tian
Yun Zhou
author_sort Hua-zhang Zhong
collection DOAJ
description Abstract Background Although anterior cervical discectomy and fusion (ACDF) is the gold standard for treating cervical spondylotic myelopathy (CSM), it still has several disadvantages in spite the used of microscope. Unilateral biportal endoscopy is a newly developed minimally invasive spine surgery and has many advantages. The study aimed to compare the feasibility, technical advantages and short-term clinical efficacy of mini-open endoscope assisted ACDF (MOEA-ACDF) versus microscopic ACDF and traditional ACDF for the treatment of single-level CSM accompanied by osteophyte formation at the posterior edge of the vertebral body or ossification of posterior longitudinal ligament. Methods Thirty-three patients who treated with MOEA-ACDF (Group A), microscopic ACDF (Group B) and traditional ACDF (Group C) were included. Before surgery, at 1 month after surgery and the last follow-up, imaging indicators (cervical Cobb angle, Cobb angle of fused segment, intervertebral space height of fused segment, intervertebral fusion status), and clinical indicators, including visual analogue scale (VAS) scores for neck and upper extremity pain, Japanese orthopedic association (JOA) score, and neck disability index (NDI) were analyzed. Results The operations were successfully completed in all groups. The mean follow-up time was 20.5 ± 2.8, 20.2 ± 4.3, and 20.3 ± 3.7 months in Groups A, B, C, respectively. Group A had longer operation time and shorter length of skin incision than Groups B and C (all P < 0.05). All patients in each group had achieved bony fusion during the follow-up period, no significant difference in the time taken for bony fusion was noted between the three groups. Imaging and clinical indicators both improved significantly at 1 month after surgery and the last follow-up compared with before surgery in all groups (all P < 0.05). There was no significant difference in imaging and clinical indicators, JOA recovery rate, and the complication rates among the three group after surgery. Conclusions For the treatment of CSM accompanied by osteophyte formation at the posterior edge of the vertebral body or OPLL, MOEA-ACDF can achieve satisfactory short-term clinical outcomes, with the advantages of high overall surgical safety, good operation accuracy, less cervical soft tissue damage, low complication rate, and fast postoperative recovery.
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spelling doaj-art-d1b58297f51247e8a4a379c19f9079c22025-08-20T02:17:49ZengBMCBMC Musculoskeletal Disorders1471-24742025-04-0126111610.1186/s12891-025-08606-yShort-term clinical outcomes and technical advantages of mini-open endoscope assisted anterior cervical discectomy and fusion in the treatment of cervical spondylotic myelopathyHua-zhang Zhong0Li Cheng1Qi-fei Wang2Bin Zhu3Lei Chen4Jue-hua Jing5Da-sheng Tian6Yun Zhou7Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Orthopaedics, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Orthopaedics, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Orthopaedics, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Orthopaedics, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Orthopaedics, The Second Affiliated Hospital of Anhui Medical UniversityDepartment of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical UniversityAbstract Background Although anterior cervical discectomy and fusion (ACDF) is the gold standard for treating cervical spondylotic myelopathy (CSM), it still has several disadvantages in spite the used of microscope. Unilateral biportal endoscopy is a newly developed minimally invasive spine surgery and has many advantages. The study aimed to compare the feasibility, technical advantages and short-term clinical efficacy of mini-open endoscope assisted ACDF (MOEA-ACDF) versus microscopic ACDF and traditional ACDF for the treatment of single-level CSM accompanied by osteophyte formation at the posterior edge of the vertebral body or ossification of posterior longitudinal ligament. Methods Thirty-three patients who treated with MOEA-ACDF (Group A), microscopic ACDF (Group B) and traditional ACDF (Group C) were included. Before surgery, at 1 month after surgery and the last follow-up, imaging indicators (cervical Cobb angle, Cobb angle of fused segment, intervertebral space height of fused segment, intervertebral fusion status), and clinical indicators, including visual analogue scale (VAS) scores for neck and upper extremity pain, Japanese orthopedic association (JOA) score, and neck disability index (NDI) were analyzed. Results The operations were successfully completed in all groups. The mean follow-up time was 20.5 ± 2.8, 20.2 ± 4.3, and 20.3 ± 3.7 months in Groups A, B, C, respectively. Group A had longer operation time and shorter length of skin incision than Groups B and C (all P < 0.05). All patients in each group had achieved bony fusion during the follow-up period, no significant difference in the time taken for bony fusion was noted between the three groups. Imaging and clinical indicators both improved significantly at 1 month after surgery and the last follow-up compared with before surgery in all groups (all P < 0.05). There was no significant difference in imaging and clinical indicators, JOA recovery rate, and the complication rates among the three group after surgery. Conclusions For the treatment of CSM accompanied by osteophyte formation at the posterior edge of the vertebral body or OPLL, MOEA-ACDF can achieve satisfactory short-term clinical outcomes, with the advantages of high overall surgical safety, good operation accuracy, less cervical soft tissue damage, low complication rate, and fast postoperative recovery.https://doi.org/10.1186/s12891-025-08606-yMini-open endoscope assisted anterior cervical discectomy and fusionSingle-level cervical spondylotic myelopathyDecompressionZero-profileClinical outcomes
spellingShingle Hua-zhang Zhong
Li Cheng
Qi-fei Wang
Bin Zhu
Lei Chen
Jue-hua Jing
Da-sheng Tian
Yun Zhou
Short-term clinical outcomes and technical advantages of mini-open endoscope assisted anterior cervical discectomy and fusion in the treatment of cervical spondylotic myelopathy
BMC Musculoskeletal Disorders
Mini-open endoscope assisted anterior cervical discectomy and fusion
Single-level cervical spondylotic myelopathy
Decompression
Zero-profile
Clinical outcomes
title Short-term clinical outcomes and technical advantages of mini-open endoscope assisted anterior cervical discectomy and fusion in the treatment of cervical spondylotic myelopathy
title_full Short-term clinical outcomes and technical advantages of mini-open endoscope assisted anterior cervical discectomy and fusion in the treatment of cervical spondylotic myelopathy
title_fullStr Short-term clinical outcomes and technical advantages of mini-open endoscope assisted anterior cervical discectomy and fusion in the treatment of cervical spondylotic myelopathy
title_full_unstemmed Short-term clinical outcomes and technical advantages of mini-open endoscope assisted anterior cervical discectomy and fusion in the treatment of cervical spondylotic myelopathy
title_short Short-term clinical outcomes and technical advantages of mini-open endoscope assisted anterior cervical discectomy and fusion in the treatment of cervical spondylotic myelopathy
title_sort short term clinical outcomes and technical advantages of mini open endoscope assisted anterior cervical discectomy and fusion in the treatment of cervical spondylotic myelopathy
topic Mini-open endoscope assisted anterior cervical discectomy and fusion
Single-level cervical spondylotic myelopathy
Decompression
Zero-profile
Clinical outcomes
url https://doi.org/10.1186/s12891-025-08606-y
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