Comparative Analysis of Clinical Outcomes: Posterior Cervical Endoscopic Discectomy versus Fenestration Laminectomy Discectomy for Cervical Disc Herniation.

ABSTRACT

Objective: It aimed to investigate the difference in clinical efficacy between posterior cervical endoscopic discectomy (PCED) and Fenestration laminectomy discectomy (FLD) in cervical disc herniation (CDH). Methods: This retrospective study analyzed 100 CDH patients undergoing nucleotomy and assigned them into the FLD and PCED groups, 50 cases for each group. The differences in operation time, intraoperative blood loss, skin incision, off-bed time, and hospital stay were evaluated. Numeric rating scales (NRS), Oswestry disability Index (ODI), Japanese Orthopaedic Association (JOA), excellent and good clinical efficacy, quality of life (QoL) SF-36 score, and complication rate were compared. Results: The results showed that compared with the FLD group, the PCED group had increased operation time, decreased intraoperative blood loss, skin incision length, off-bed time, and hospital stay (P < .01). Compared with the FLD group, the PCED group had decreased NRS and ODI scores and increased JOA scores at 1 d, 3 d, 1 month, 3 months, 6 months, 12 months, and 24 months after operation (P < .05). Compared with the FLD group, the excellent and good rate of the PCED group increased significantly after 6 months, 1 year, and 2 years (52.0% vs 64.0%, 58.0% vs. 80.0%, 68.0% vs 90.0%, P < .05). Relative to the FLD group, the physical function, emotional function, vitality, social function, and mental health score of the PCED group increased obviously at 2 years after operation (P < .01). The postoperative complication rate was 0% in both FLD and PCED groups. PCED has good long-term clinical efficacy in the treatment of CDH, with excellent recovery and high safety. Conclusion: PCED showed favorable long-term clinical efficacy in the treatment of CDH, with excellent recovery and high safety. Compared to FLD, PCED resulted in reduced intraoperative blood loss, shorter incision length, and faster recovery. It also led to improved pain scores, functional outcomes, and quality of life measures. The absence of postoperative complications further supports the use of PCED as an effective treatment option for CDH.