Clinical and Functional Outcomes of Posterior Endoscopic Decompression for Symptomatic Cervical Disc Herniation

Posterior endoscopic decompression is a minimally invasive alternative for symptomatic cervical disc herniation management. We aimed to evaluate the clinical and functional outcomes of posterior endoscopic decompression in patients with symptomatic cervical disc herniation. The objectives were to assess postoperative improvement in pain and disability, determine patient-reported functional outcomes using the Modified MacNab criteria, and analyze the influence of demographic and clinical variables on surgical success.

This single-center study included 145 patients with symptomatic cervical disc herniation treated with posterior endoscopic decompression. Preoperative and postoperative assessments included Visual Analog Scale (VAS) scores for arm and neck pain and Neck Disability Index (NDI) scores. Patients were followed up at 1, 6, and 12 months postoperatively. Functional outcomes were evaluated using the Modified MacNab criteria. Statistical analysis was performed using repeated-measures analysis of variance and Pearson's chi-squared test, with significance set at p < 0.05.

The study included 82 (56.6%) males and 63 (43.4%) females with a mean age of 48.3 ± 9.7 years. The most commonly affected levels were C5-C6 in 61 (42.1%) patients and C6-C7 in 59 (40.7%). Mean arm pain VAS score significantly improved from 7.6 ± 1.2 preoperatively to 1.9 ± 1.0 at 12 months (p < 0.001). Mean neck pain VAS score decreased from 5.1 ± 1.8 to 2.2 ± 1.1 (p < 0.001), while mean NDI score improved from 54.3 ± 10.5 to 19.8 ± 8.2 (p < 0.001). According to the Modified MacNab criteria, excellent outcomes were observed in 72 patients (49.7%), and good outcomes were observed in 48 patients (33.1%), resulting in an overall success rate of 82.8%. Paracentral disc herniation demonstrated significantly better outcomes than foraminal herniation (p = 0.042).

Posterior endoscopic decompression provides significant pain relief, functional improvement, and favorable clinical outcomes in patients with symptomatic cervical disc herniation, representing an effective and minimally invasive surgical treatment option.