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Randomized Controlled Trial
. 2009 Dec;33(6):1677-82.
doi: 10.1007/s00264-008-0684-y. Epub 2008 Nov 18.

Full-endoscopic anterior decompression versus conventional anterior decompression and fusion in cervical disc herniations

Sebastian Ruetten  1 , Martin Komp, Harry Merk, Georgios Godolias
Affiliations
Randomized Controlled Trial

Full-endoscopic anterior decompression versus conventional anterior decompression and fusion in cervical disc herniations

Sebastian Ruetten et al. Int Orthop. 2009 Dec.

Abstract
in English, French

Anterior cervical decompression and fusion (ACDF) is the standard for cervical discectomies. With the full-endoscopic anterior cervical discectomy (FACD) a minimally invasive procedure is available. The objective of this prospective, randomised, controlled study was to compare the results of FACD with those of ACDF in mediolateral soft disc herniations. A total of 103 patients with ACDF or FACD were followed up for two years. In addition to general parameters specific measuring instruments were used. Postoperatively 85.9% of the patients no longer had arm pain, and 10.1% had occasional pain. There were no significant clinical differences between the decompression with or without fusion. The full-endoscopic technique afforded advantages in operation technique, rehabilitation and soft tissue injury. The recorded results show that FACD is a sufficient and safe alternative to conventional procedures when the indication criteria are fulfilled. At the same time, it offers the advantages of a minimally invasive intervention.

La décompression cervicale antérieure avec greffe (ACDF) est un standard de la chirurgie cervicale avec discectomies. La discectomie endoscopique FACD par voie mini-invasive est également possible. L’objectif de cette étude prospective randomisée est de comparer les résultats de cette technique endoscopique mini-invasive FACD avec la technique classique ACDF. 103 patients ayant bénéficié soit d’une ACDF soit d’une FACD ont été suivis pendant une moyenne de deux ans. après l’intervention, 85,9% des patients ne présentent aucune douleur au niveau brachial et 10,1% des douleurs occasionnelles. Il n’y a pas de différence significative que l’on ait réalisé ou non une greffe. La technique par endoscopie présente des avantages pratiques notamment en ce qui concerne la rééducation et les lésions des tissus en post-opératoires. le résultat montre que la technique FACD est une technique suffisamment sûre et es-t une alternative valable à la technique conventionnelle lorsque les critères d’indication ont été respectés. Cette technique a par ailleurs les avantages de la voie mini-invasive.

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Figures

Fig. 1
Fig. 1
Optic in oval sheath with inserted rongeur
Fig. 2
Fig. 2
Mean values of VAS arm and neck in the ACDF and FACD groups
Fig. 3
Fig. 3
Mean values of NASS pain and neurology in the ACDF and FACD groups
Fig. 4
Fig. 4
Clinical results according to Hilibrand criteria in the ACDF group
Fig. 5
Fig. 5
Clinical results according to Hilibrand criteria in the FACD group
See this image and copyright information in PMC

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