Full-Endoscopic Posterior Cervical Decompression Versus Anterior Cervical Discectomy and Fusion: A Systematic Review...

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Minimally Invasive Spine Procedures

Background:

• Degenerative cervical disease presents a significant challenge in spinal surgery.
• Anterior cervical discectomy and fusion (ACDF) is a common treatment, but carries risks.
• Full-endoscopic posterior cervical decompression (PECD) is an emerging alternative.

Purpose of the Study:

• To compare the efficacy and safety of PECD versus ACDF for degenerative cervical disease.
• To evaluate patient-reported outcomes, radiographic changes, and perioperative metrics.
• To assess complication rates between the two surgical techniques.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials and cohort studies.
• Searched PubMed, Embase, and CENTRAL for studies comparing PECD and ACDF in adults.
• Pooled data on Neck Disability Index (NDI), Visual Analog Scale (VAS) pain, C2-C7 Cobb angle, peri-operative metrics, and adverse events.

Main Results:

• No significant difference in NDI or arm pain at final follow-up between PECD and ACDF.
• PECD demonstrated superior short-term functional improvement and ACDF offered marginally better long-term neck pain relief.
• PECD was associated with shorter hospital stays, less blood loss, and a lower risk of postoperative complications compared to ACDF.

Conclusions:

• PECD provides comparable mid-term disability and arm pain relief to ACDF.
• PECD offers advantages in early recovery and reduced perioperative morbidity.
• ACDF may provide slightly superior long-term axial neck pain improvement.