The Current State of Cervical Endoscopic Spine Surgery: an Updated Literature Review and Technical Considerations

Introduction: Endoscopic spine surgery has become one of the representative minimally invasive spine surgeries (MISS), especially in the lumbar spine. Full-endoscopic procedures using a working channel endoscope for cervical degenerative spine disease have been reported as practical and feasible. This review aimed to summarize the updated techniques of and studies about cervical endoscopic surgery. Areas covered: An extensive search of PubMed was performed for randomized controlled trials (RCTs) or comparative cohort studies on the full-endoscopic cervical procedure. All the 236 articles found were screened and categorized. Only two RCTs and four cohort studies finally met the search criteria. Regarding the surgical techniques, there are four categories according to the approach method: 1) anterior endoscopic cervical discectomy (AECD); 2) anterior endoscopic cervical transcorporeal decompression (AECTcD); 3) posterior endoscopic cervical foraminotomy and discectomy (PECFD); and 4) posterior endoscopic cervical laminotomy (PECL). Expert opinion: Cervical endoscopic surgery provides comparable clinical results with MISS benefits, such as shorter operative time, less bleeding, and earlier recovery time. However, spine surgeons are not yet familiar with most of these techniques; moreover, supportive evidence is minimal. Technical evolution is still ongoing in an effort to make the procedure more practical.