Current status of full-endoscopic spine surgery in cervical spine: Anterior and posterior approach

The techniques for the treatment of cervical disc herniation and cervical myelopathy have evolved over the last two decades. Anterior cervical decompression and fusion has been considered to be the gold standard technique to date. Recently, it has been shown that full-endoscopic spine surgery with upgraded technology and instrumentation has the capability to decompress the exiting nerve root and thecal sac effectively in the cervical spine. Good clinical outcomes have been reported in the literature with endoscopic procedures. The full-endoscopic spine technique can be an alternative to avoid interbody fusion surgeries. Successful decompression under constant visualization with a small incision and minimal surgical trauma can be achieved. There are two percutaneous endoscopic cervical spine approaches: anterior and posterior. Decision-making depends on anatomical and pathological considerations. Attaining full-endoscopic cervical spine technique requires a steep learning curve, practical training under the experts, and proper selection of patients. The recent developments related to endoscopic equipment with the availability of better optics, three-dimensional monitors, lighting systems, and newer generation endoscopes have made these techniques applicable in complex surgeries as well. The objective of this review was to provide a technical description of full-endoscopic anterior and posterior cervical spine surgeries and their current status in management of various cervical spine pathologies.