4.4 Review

Minimally invasive posterior cervical foraminotomy versus anterior cervical discectomy and fusion for cervical radiculopathy: a meta-analysis

Journal

NEUROSURGICAL REVIEW
Volume 45, Issue 6, Pages 3609-3618

Publisher

SPRINGER
DOI: 10.1007/s10143-022-01882-5

Keywords

MIS-PCF; ACDF; Clinical outcomes; Meta-analysis

Funding

  1. Lvyang Jinfeng Talent Project of Yangzhou City [LYJF00027]
  2. Jiangsu Innovative and Enterpreneurial Talent Programme [JSSCBS20211597]

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This study aimed to evaluate the therapeutic effects of MIS-PCF and ACDF on unilateral cervical radiculopathy. The results showed that MIS-PCF had a significantly shorter postoperative hospitalization time compared to ACDF, and the operation time, complication/reoperation rate, and VAS-arm, VAS-neck, and NDI scores were comparable between the two methods. In North America, the average cost of MIS-PCF was lower than ACDF. Therefore, MIS-PCF can be an alternative to ACDF.
With the recent development of minimally invasive techniques, minimally invasive posterior cervical foraminotomy (MIS-PCF) has become increasingly popular as a minimally invasive method to treat cervical radiculopathy. However, there are still controversies about whether MIS-PCF is superior to anterior cervical discectomy and fusion (ACDF). The purpose of this study is to evaluate the therapeutic effects of MIS-PCF and ACDF on unilateral cervical radiculopathy without myelopathy. We searched PubMed, Embase, the Cochrane Library, and Scopus comprehensively using the terms related to MIS-PCF. Two reviewers independently evaluated the potential studies, and extracted and analyzed the data of operation time, hospital stay, neck disability index (NDI) score, visual analog scale for neck pain (VAS-neck) and arm pain (VAS-arm) scores, reoperation rate, and complications. Seven studies with 1175 patients were included. The study population was 53.5% male, with a mean age of 48.9. MIS-PCF presented a significantly shorter postoperative hospitalization time compared to ACDF, while the operation time, complication/reoperation rate, and VAS-arm, VAS-neck, and NDI scores were comparable between the two cohorts. In North America, the average cost of MIS-PCF is lower than ACDF. Thus, we suggest that MIS-PCF is an alternative to ACDF for selected patients.

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