Abstract

Objective: Cervical Spondylitis Myelopathy (CSM) is a serious degenerative disease that significantly affects the life quality of patients. Surgical treatment remains the preferred choice. However, traditional open decompression and fusion surgery can cause considerable trauma to patients with CSM. In recent years, some scholars have proposed full endoscopic surgery, which also has its drawbacks, especially in anterior cervical approaches, as it relies on general anesthesia and lacks effective protective measures for the trachea and esophagus.
Methods: In this study, we made a first attempt to perform Endoscopic Anterior Cervical Canal Decompression (EACCD) with trans vertebral approach for CSM under Local Anesthesia. Its effectiveness and safety were also observed. Eleven patients were included. The therapeutic efficacy was evaluated by Visual Analog Scale (VAS), modified Japanese Orthopaedic Association (mJOA) score, and total efficacy rate at pre-operation and post-operation 1, 3 and 6 months.
Result: All cases achieved good therapeutic effects. The VAS and mJOA were significantly improved at different follow-up time points compared with the pre-surgery. The total efficacy rate at post-operation 1, 3 and 6 months was 0, 18.18% and 72.73% respectively. No severe complications were observed.
Conclusions: This research provides a new surgical option for better treating CSM. Compared to surgery under general anesthesia with endotracheal intubation, EACCD under local anesthesia offers patients a more comfortable experience and a safer medical model, further shortening the duration of surgical trauma and hospital stay. Additionally, directly observing the esophagus under the endoscope avoids the extra impacts of the gastric tube and contrast agent on the CSM patients.

Keywords:Endo-PCCD; Lateral decubitus position; Local anesthesia; VAS; NDI; mJOA

Abbreviations: CSM: Cervical Spondylotic Myelopathy; CT: Cervical Computed Tomography; EACCD: Endoscopic Anterior Cervical Canal Decompression; ECG: Electro Car Diogram; Endo-PCCD: Endoscopic Posterior Cervical Canal Decompression; mJOA: Modified Japanese Orthopaedic Association Scores; MRI: Magnetic Resonance Imaging; OPLL: Ossification of the Posterior Longitudinal Ligament; VAS: Visual Analog Scale.