• Spine · Nov 2013

    Randomized Controlled Trial

    Cervical microendoscopic discectomy and fusion: does it affect the postoperative course and the complication rate? A blinded randomized controlled trial.

    • Hesham Magdi Soliman.
    • From the Faculty of Medicine, Cairo University, Abd Elaziz Alseoud, Manial-Roda, Cairo, Egypt.
    • Spine. 2013 Nov 15;38(24):2064-70.

    Study DesignA blinded randomized controlled trial.ObjectiveThe purpose of this study was to evaluate the cervical microendoscopic discectomy and fusion.Summary Of Background DataMinimally invasive treatment of spinal disorders allows surgeons to have direct access to the pathology with a reduced surgical morbidity, which is reflected over the improved postoperative course. Minimally invasive techniques for cervical discectomy including the posterior microendoscopic discectomy and the percutaneous endoscopic discectomy have a high success rate but are limited by the narrow range of indications. Lately, preliminary reports about cervical microendoscopic discectomy and fusion (CMEDF) showed high success rates without restrictions in the indications.MethodsSeventy consecutive patients were randomly assigned in 2 equal groups, the first operated by the "gold standard" anterior cervical discectomy and fusion and the second by CMEDF. Blinding included the patient-until dressing removal, the evaluating physician, and the radiologist throughout the entire study. The mean follow-up period was 28 months and outcome has been assessed using the Japanese Orthopaedic Association score, Odom criteria and the visual analogue scale. In addition, the operative time, complication rate, hospitalization, and the postoperative analgesic doses were recorded.ResultsThe functional outcome of the CMEDF at the final follow-up was 91% good to excellent. Results in the open group were very similar. Meanwhile, CMEDF demonstrated improved cosmesis, reduced laryngopharyngeal complication rate, postoperative analgesics, and hospital stay.ConclusionThe results of the CMEDF are very promising. However, a much larger patient series from multicenter studies is still required for drawing up a final conclusion.Level Of Evidence1.

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