Comparative outcomes of transcorporeal vs trandiscal anterior endoscopic discectomy for cervical radiculopathy: a systematic review and meta-analysis

Abstract

Abstract Introduction: In recent years, the anterior transdiscal approach (td) endoscopic cervical discectomy (PECD) can provide direct decompression for central or paramedian cervical disc herniation, the iatrogenic disc damage may result in decreased intervertebral space. Anterior transcorporeal approach (tc) PECD could enable an individual and adjustable trajectory within the vertebral body under different conditions of disc herniation preserving the motion of the adjacent segment. However, there is no consensus regarding which method is better. Material & Methods: This systematic review was conducted according to the PRISMA guidelines. Relevant studies were identified from Medline and Scopus from inception to Octrober 23th, 2022. Results: Twelve studies and 17 were included for analysis of td PECD and tc PECD. One comparative study was included for comparison of td to tc PECD. A pooled UMD of post-operative neck pain, arm pain (VAS) and disability (NDI) scores of transdiscal PECD and transcorporeal PECD were significantly improved when compared to before surgery. The pooled prevalence of having excellent and good results in modified Macnab criteria, complications and reoperation of td PECD and tc PECD were 0.94 (95%CI: 0.92 to 0.96), 0.03 (95%CI: 0.01 to 0.05), 0.03 (95%CI: 0.01 to 0.04) and 0.90 (95%CI: 0.84 to 0.96), 0.08 (95%CI: 0 to 0.19), 0.05 (95%CI: 0.01 to 0.08). By indirect meta-analysis, td PECD have no significantly difference in all outcomes when compared to tc PECD technique. Conclusion: In post-operative outcomes at 3 to 4 years follow-up, there is no significant difference in all clinical outcomes between the 2 approaches. Trial registration number: Prospero registered No 378776