• Leonello Tacconi and Enrico Giordan.
• Department of Neurosurgery, University Hospital of Trieste, Trieste, Italy.
• World Neurosurg. 2019 Nov 1; 131: e237-e246.

BackgroundWe describe our experience in the endoscopic treatment of cervical spondylosis. We present a "hybrid" technique that is similar to an open anterior cervical discectomy with fusion but is performed endoscopically. We also analyzed data from studies on endoscopic cervical discectomies published in the past 2 decades.MethodsWe prospectively collected and analyzed data on all patients who underwent endoscopic cervical discectomy and fusion from January 2017 to January 2019. Data included age, sex, location, diagnosis, arm pain, degree of myelopathy and disability, and adverse events. Also, several databases were explored from January 1998 to December 2018, and 11 studies describing data about the anterior endoscopic treatment of cervical spondylosis, with and without fusion, were retrieved. We pooled these studies into a meta-analysis.ResultsArm pain decreased from a preoperative mean visual analogue scale value of 7 to a postoperative value of 2.1, and Nurick grade improved from a mean value of 3.1 to 1.8 at 12 months. 36-Item Short Form Survey scores increased from a mean preoperative value of 67 to 83.2, whereas the mean Oswestry Disability Index score decreased from 65.7 to a final mean value of 23.1 at 12 months. Median hospitalization time was 36 hours. Our meta-analysis found a satisfactory outcome in 88% of patients at last follow-up, an overall recurrence rate of 3%, and a revision rate of 5%.ConclusionsWe described the feasibility and safety of anterior hybrid endoscopic cervical discectomy, overcoming some of the limitations of the previously described percutaneous discectomies and shifting the standard open technique into an endoscopic procedure.Copyright © 2019 Elsevier Inc. All rights reserved.

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