Page 74 - JCTR-9-4

Journal of Clinical and Translational Research 2023; 9(4): 290-296

Journal of Clinical and Translational Research

Journal homepage: http://www.jctres.com/en/home

ORIGINAL ARTICLE

Does the endoscopic keyhole technique have advantages over the

microscopic keyhole technique for treating cervical radiculopathy?

Shutong Xu , Junlong Zhong , Zhenhai Zhou , Hao Lv , Jiachao Xiong , Shengbiao Ma , Zhimin Pan , Yong Zhang ,
1
1
2
1
1
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Kai Cao *
1
1 The Orthopedic Hospital, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China, Department of Pain, The First Affiliated
2
Hospital of Nanchang University, Nanchang, 330006, China
ARTICLE INFO Abstract
Article history: Background: Both endoscopic keyhole and microscopic keyhole techniques are considered minimally
Received: February 6, 2023 invasive approaches. However, it is still unclear which is superior in treating cervical radiculopathy.
Revised: March 27, 2023 Aim: This study aimed to compare the clinical outcomes of the two methods for cervical radiculopathy.
Accepted: June 10, 2023 Methods: Seventy-one patients with cervical radiculopathy caused by single-level disc herniation
Published online: July 28, 2023 were retrospectively reviewed. These patients were treated with the endoscopic keyhole technique
(EKT) (34 cases, classified as EKT group) or the microscopic keyhole technique (37 cases, classified
Keywords: as MKT group). Magnetic resonance imaging (MRI), neck disability index (NDI), and visual analog
Cervical radiculopathy scores (VAS) were employed to assess clinical outcomes. All patients were followed up for at least
Endoscopy 24 months.
Keyhole discectomy Results: The average operative time (71.0 ± 15.2 min vs. 63.7 ± 18.9 min, P = 0.131), blood loss
Microscopy (56.1 ± 18.2 ml vs. 64.4 ± 13.5 ml, P = 0.068), and hospital stay (24.9 ± 5.6 h vs. 28.3 ± 7.1 h,
Learning curve P = 0.061) between the EKT and MKT groups were not significantly different. Postoperative MRI
Microscopic keyhole technique demonstrated that effective neural decompression was obtained in all cases after surgery. The NDI
Endoscopic keyhole technique in both groups was significantly decreased from pre- to postoperatively (EKT group: 32.8 ± 9.4 vs.
9.2 ± 3.6, P < 0.001; MKT group: 36.2 ± 11.3 vs. 10.5 ± 4.1, P < 0.001), VAS (EKT group: 5.6 ±
*Corresponding authors: 2.3 vs. 1. 5 ± 1.0, P < 0.001; MKT group: 6.2 ± 2.1 vs. 1.9 ± 0.8, P < 0.001). Nine patients in the EKT
Kai Cao, group underwent revision surgery due to recurrent disc herniation compared with 2 patients in the
The Orthopedic Hospital, The First Affiliated MKT group (P = 0.034). The interval time from primary surgery to revisional surgery was shorter in
Hospital of Nanchang University, Nanchang, the EKT group than in the MKT group (21 ± 5.8 weeks vs. 29 ± 7.2 weeks, P < 0.001). There were
330006, China. 2 patients with temporary nerve root irritation and 1 patient with cerebrospinal fluid leak that occurred
E-mail: kaichaw@126.com in the EKT group versus 1 patient who suffered nerve root irritation in the MKT group (P = 0.547).
Yong Zhang, Conclusions: Both EKT keyhole and microscopic keyhole techniques are effective in treating cervical
Department of Pain Clinic, The First Affiliated radiculopathy. However, compared with the microscopic keyhole technique, the EKT brings about a
Hospital of Nanchang University, Nanchang, higher revision surgery rate with a shorter interval time from index surgery to revision surgery.
Jiangxi Province, 330209, China.
E-mail: zy830226@163.com Relevance for Patients: These findings suggest that the microscopic keyhole technique seems to be a
better way of treating cervical radiculopathy.
© 2023 Author(s). This is an Open-Access
article distributed under the terms of the
Creative Commons Attribution-Noncommercial 1. Introduction
License, permitting all non-commercial use,
distribution, and reproduction in any medium, Cervical radiculopathy is defined as a clinical syndrome of sensorimotor deficits due to
provided the original work is properly cited.
compression on the cervical nerve root [1]. Facet joint spondylosis and herniation of the
intervertebral disc are the most common causes of nerve root compression [2]. Patients
present with pain, tingling, numbness, or even weakness in the upper extremity [2].
Surgical management for cervical radiculopathy mainly includes anterior cervical
discectomy and fusion (ACDF), cervical foraminotomy via an anterior or posterior approach,
DOI: http://dx.doi.org/10.18053/jctres.09.202304.23-00023