Complications of Full-endoscopic versus Microendoscopic Foraminotomy for Cervical Radiculopathy: a Systematic Review and Meta-analysis.

Complications of Full-endoscopic versus Microendoscopic Foraminotomy for Cervical Radiculopathy: a Systematic Review and Meta-analysis.

World Neurosurg. 2018 Mar 27;:

Authors: Wu PF, Liu BH, Li YW, Wang B, Dai YL, Qing YL, Lv GH

Abstract
INTRODUCTION: Minimally invasive surgery of posterior cervical foraminotomy (PCF) for symptomatic radiculopathy has gained popularity in the last decade. As two dominant techniques, whether full-endoscopic (FE) or microendoscopic (MI) operations are associated with fewer complications remains to be determined.
METHODS: An electronic retrieval from PubMed, Embase and Web of Science was performed to identify comparative or single-arm studies concerning FE-PCF and MI-PCF. The pooled incidence of complications was calculated.
RESULTS: A total of 26 studies with 2028 patients (FE, 402; MI, 1626) were identified. Overall complication rate was 5.8% for FE-PCF and 3.5% for MI-PCF with no significant difference (P=0.115). The pooled complication rate for single-level radiculopathy demonstrated no statistical difference (FE, 4.5%; MI, 3.5%; P=0.471), either. However, constituent of complications showed apparent disparity, with transient root palsy in FE-PCF (15/19, 78.9%) and dural tear (20/47, 42.6%) in MI-PCF being the most commonly reported. As for the subgroup analysis, both incidence of dural tear (FE, 1.5%; MI, 1.8%; P=0.672) and superficial wound infection (FE, 2.2%; MI, 1.0%; P=0.109) showed no statistical difference. Nevertheless, transient root palsy occurred at a higher incidence in the FE group than in the MI group (FE, 4.5%; MI, 1.5%; P=0.002).
CONCLUSION: Both FE-PCF and MI-PCF can offer relatively safe treatment for cervical radiculopathy. There is no significant difference in overall complication rate between two techniques. Dural tear is the most commonly reported complication of MI-PCF, whereas transient root palsy deserves to be noticed for surgeons performing FE-PCF.

PMID: 29602008 [PubMed - as supplied by publisher]

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