Comparison of surgical outcomes between posterior percutaneous endoscopic cervical discectomy and microscope-assisted ACDF in patients with single-level unilateral radicular symptomatology of cervical disc herniation: a single-center retrospective study.

objectiveTo compare surgical outcomes between the posterior percutaneous endoscopic cervical discectomy (PPECD) and microscope-assisted ACDF for the treatment of single-level unilateral radicular symptomatology of cervical disc herniation. OVERVIEW OF LITERATURE: Microscope-assisted Anterior cervical discectomy and fusion (ACDF) is the standard surgical procedure for treating symptomatic cervical disc herniation. Posterior Percutaneous Endoscopic Cervical Discectomy (PPECD) has developed rapidly in recent years. However, comparative evidence on efficacy, safety, and recovery profiles remains limited.

methodsThis was a single-center retrospective analysis of 110 patients with single-level unilateral radicular symptomatic cervical disc herniation who underwent either the PEPCD surgery (n = 57) or microscope-assisted ACDF (n = 53) between January 2019 and December 2023. Demographic information, perioperative data, and pain measurements were reviewed. Pain intensity, quality of life, and patient satisfaction were assessed using the Visual Analog Scale (VAS), the Neck Disability Index (NDI) and the modified MacNab criteria at 3 days, 1 month, 6 months, and 12 months follow-ups.

resultsThe mean postoperative hospitalization in the PPECD (3.0 ± 0.9 days) was significantly shorter than in the ACDF group (5.0 ± 0.9, days, p < 0.001). the postoperative VAS scores of neck/upper extremity pain and NDI scores of the patients in the two groups improved significantly compared with that of the preoperative period (P < 0.05), and the difference was not statistically significant when comparing between the two groups (P > 0.05). At 12 months postoperatively, the modified MacNab criteria evaluation showed an excellent and good rate was 83% in the PPECD and 80.7% in the ACDF group, and ther was no statistically significant difference.

conclusionThe clinical efficacy of PPECD and microscope-assisted ACDF are both satisfactory. The findings suggest comparable short-term clinical improvement between the two groups. Both ACDF and PPECD resulted in significant improvement in clinical outcomes at 12 months postoperatively. While perioperative metrics favored PPECD, the findings suggest comparable short-term clinical improvement between the two groups. LEVEL OF EVIDENCE: Level of evidence level Ⅲ, therapeutic study.