Complications in Full-Endoscopic Posterior Cervical Surgery: A Review of the Literature and Preventive Strategies

Study Design: Narrative review Objectives: Full-endoscopic cervical spinal surgery via a posterior approach has gained popularity for its effectiveness in treating various cervical spine pathologies. However, this technique presents its own set of complications that need to be recognized and addressed. This review aims to comprehensively analyze the complications associated with full-endoscopic posterior cervical spine surgery and provide preventive strategies to minimize these risks and ensure successful surgical outcomes. Methods: A thorough literature search was conducted using public databases, including PubMed and SCOPUS, from January 2000 to June 2024. The review focused on analyzing complications related to full-endoscopic posterior cervical spine surgery and identifying preventive strategies using the keywords “Complication,” “Endoscopic,” “Full-endoscopic,” “Endoscopy,” “Uniportal,” “Biportal,” “Posterior,” “Cervical,” “Spine,” “Surgery,” “Foraminotomy,” “Decompression,” and “Discectomy”. Results: The review identified a variety of complications associated with full-endoscopic posterior cervical spine surgery, including neurological, vascular, and structural issues. Despite the minimally invasive benefits of this approach, risks such as nerve root injury, dural tears, and epidural hematomas still exist. The study emphasizes preventive strategies like meticulous preoperative planning, refined surgical techniques, and cautious intraoperative management around neural structures to mitigate these risks. Conclusions: While full-endoscopic posterior cervical spine surgery provides significant advantages, such as reduced tissue disruption and quicker recovery, it also carries specific complications that must be carefully addressed and managed. Prevention is crucial for ensuring optimal outcomes. By understanding potential risks and implementing effective prevention strategies, surgeons can significantly reduce complications and enhance patient safety.