BACKGROUND ACDF is the standard procedure for treatment of cervical spondylotic myelopathy (CSM), but a long-term follow-up has been revealed some associated complications of swallowing discomfort, displacement of the fusion device, and accelerated degeneration of the adjacent segment. OBJECTIVE To evaluate the clinical outcomes of anterior percutaneous full-endoscopic transcorporeal decompression of the spinal cord (APFETDSC) for single-segment CSM and to analyze the clinical efficacy, surgical characteristics, and complication prevention. METHODS A total of 32 patients who underwent APFETDSC for single-segment CSM from Aug. 2015 to Apr. 2017 were reviewed. Operating time, time of walking out of bed postoperation, length of hospitalization, complications, neck pain visual analog scale (VAS), and Japanese Orthopaedic Association Score (JOA) were evaluated. Measurement of intervertebral height (HI) of surgical segments on cervical neutral X-ray, Harrison's method was used to measure cervical spine angle (CSA). RESULTS The operation time was 103.3 ± 12.95 min, time of walking out of bed after surgery was 19.81 ± 4.603 h, the length of postoperative hospital stay was 57.48 ± 19.48 h. The postoperative neck pain VAS and JOA were significantly improved compared with preoperation(p < 0.001). The postoperative HI was statistical significance decreased compared with preoperation(p < 0.001), but the HI reduction was less than 0.5 mm, without adverse clinical symptoms. The postoperative CSA was significantly improved compared with preoperative(p < 0.001). The excellent and good rate was 87.5%, and the JOA improvement rate was 75.52 ± 11.11%. There was no cervical instability, vertebral fracture, wound infection, and other complications. CONCLUSIONS APFETDSC is a safe and effective minimally invasive technique with small auxiliary injuries for single-segment CSM while avoiding the sequelae of ACDF. Its short-term clinical efficacy was good and no significant effect on cervical stability.

中文翻译：

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前路经皮全内镜经体脊髓减压治疗单节段脊髓型颈椎病：技术解读和 2 年临床随访。

背景ACDF是治疗脊髓型颈椎病（CSM）的标准手术，但长期随访发现存在一些相关并发症，如吞咽不适、融合装置移位和邻近节段加速退变。目的评价前路经皮全内镜下经体脊髓减压术(APFETDSC)治疗单节段CSM的临床效果，分析其临床疗效、手术特点及并发症预防。方法回顾性分析2015年8月至2017年4月期间接受APFETDSC单节段CSM治疗的32例患者。评估手术时间、术后下床行走时间、住院时间、并发症、颈部疼痛视觉模拟量表（VAS）和日本骨科协会评分（JOA）。颈椎中性X线测量手术节段椎间高度（HI），采用Harrison法测量颈椎角度（CSA）。结果 手术时间103.3±12.95 min，术后下床活动时间19.81±4.603 h，术后住院时间57.48±19.48 h。术后颈部疼痛VAS和JOA较术前明显改善(p < 0.001)。术后HI较术前有统计学意义下降(p < 0.001)，但HI下降小于0.5 mm，无不良临床症状。术后CSA较术前显着改善(p < 0.001)。优良率为87.5%，JOA改善率为75.52±11.11%。无颈椎不稳、椎体骨折、伤口感染等并发症。结论 APFETDSC对于单节段CSM来说是一种安全有效、辅助损伤小、同时避免ACDF后遗症的微创技术。其近期临床疗效良好，且对颈椎稳定性无明显影响。