Clinical and Radiological Outcomes of Single-Level Full Endoscopic Posterior Cervical Foraminotomy and Herniectomy: A 12 months Follow-up

Hung The Dinh,1,2,* Son Ngoc Dinh,1,2,* Long Hoang Nguyen,2 Hung Manh Do,2 Thach Van Nguyen,2 Cuong Van Vu2 1Faculty of Surgery, Ha Noi Medical University, Hanoi, Vietnam; 2Department of Spine Surgery, Viet Duc University Hospital, Hanoi, Vietnam*These authors contributed equally to this workCorrespondence: Cuong Van Vu, Department of Spine Surgery, Viet Duc University Hospital, 40 Trang Thi Str, Hoan Kiem, Ha Noi, 100000, Vietnam, Email [email protected]: To date, no comprehensive study has evaluated the outcomes of single-level full endoscopic posterior cervical foraminotomy and herniectomy in Vietnam.Methods: This prospective, descriptive study was conducted before and after spinal disc herniation surgery at the Department of Spine Surgery, Viet Duc University Hospital, Hanoi, Vietnam, from March 2023 to December 2024. All patients follow-up during the 12 months with clinical, radiological and image outcomes.Results: The study included 47 patients, with 23 males (48.9%) and 24 females (51.1%), with a mean age of 44.46 ± 8.47 years old. The location of the operated disc was predominantly at the C5-C6 level (61.7%) with 10.34 ± 0.7 incision length. The recovery outcomes revealed a strong trend toward excellent and good results, totalling 93.6% of the positive outcomes. A statistically significant reduction in all measured parameters over time (the Numerical Rating Scale (NRS) for pain and the Neck Disability Index (NDI) at multiple time points: pre-operation, post-operative day 1, and 1, 6, and 12 months post-operation) compared to pre-operative baseline values (p < 0.0001 for all comparisons). Radiological outcomes showed significantly improved cervical neural curvature from to C2-C7 at all the postoperative time points. Foraminal dimensions (height, diameter, and area) showed significant immediate postoperative increases. Disc height decreased significantly, while cervical range of motion showed variable changes. C2-C7 SVA and T1 slope remained stable, indicating no significant changes in the global alignment. Complications were generally low; two patients had intraoperative nerve root injury, and one patient had transient root palsy.Conclusion: This study demonstrated that single-level full endoscopic posterior cervical foraminotomy and herniectomy are safe in the short-term with 12 months of follow-up and effective in the treatment of cervical disc herniation. Further study is needed with a larger sample size, with control group and long-term follow-up.Keywords: clinical outcomes, radiological outcomes, single-level full endoscopic posterior cervical foraminotomy and discectomy, disc herniation