Abstract:Objective To evaluate the safety, feasibility, and clinical outcome of anterior percutaneous endoscopic cervical discectomy (PECD). Methods The study involved 28 patients undergone PECD. Visual analogue scale (VAS) and MacNab scale were recorded before operation and at 3 days, 1, 3, 6, 12 and 18 months after operation. In addition, MRI examination was conducted at postoperative 1 month, 3 months and 12 months. After data collection, single-factor T test with SAS software was performed. Results Follow-up (range, 18-24 months, mean 19 months) was achieved in 25 patients. When compared to the preoperative score, VAS and MacNab scale presented improvement at postoperative 3 days (P>0.05) and great improvement at postoperative 1, 3, 6, 12, 18 and 24 months (P<0.01). VAS and MacNab scale at postoperative 3 days presented statistical differences as compared to those at postoperative 3, 6, 12 and 18 months (P<0.05), but the differences were not statistically insignificant at postoperative 3, 6, 12, and 18 months (P>0.05). Moreover, VAS and MacNab scale showed significant improvement at postoperative 24 months as compared to those before operation (P<0.01) and those at postoperative day 3 (P<0.01). Conclusion Anterior PECD is effective in treatment of cervical soft or partial hard disc herniation.
CHEN Liang,KE Zhen-yong,CHU Lei et al. Clinical application of anterior percutaneous endoscopic cervical discectomy[J]. CHINESE JOURNAL OF TRAUMA, 2013, 29(7): 602-607.
[1]Cloward RB. The anterior approach for removal of ruptured cervical disks. J Neurosurg, 1958, 15(6):602-617.
[2]Robinson IB, Sarnat BG. Growth pattern of the pig mandible: a serial roentgenographic study using metallic implants. Am J Anat, 1955, 96(1):37-64.
[3]Angevine PD, Arons RR, McCormick PC. National and regional rates and variation of cervical discectomy with and without anterior fusion, 1990-1999. Spine, 2003, 28(9):931-939; discussion 940.
[4]Lee SH, Lee JH, Choi WC, et al. Anterior minimally invasive approaches for the cervical spine. Orthop Clin North Am, 2007, 38(3):327-337; abstract v.
[5]Gala VC, O'Toole JE, Voyadzis JM, et al. Posterior minimally invasive approaches for the cervical spine. Orthop Clin North Am, 2007, 38(3):339-349; abstract v.
[8]Ahn Y, Lee SH, Park WM, et al. Percutaneous endoscopic lumbar discectomy for recurrent disc herniation: surgical technique, outcome, and prognostic factors of 43 consecutive cases. Spine, 2004, 29(16):E326-E332.
[9]Choy DS. Response of extruded intervertebral herniated discs to percutaneous laser disc decompression. J Clin Laser Med Surg, 2001, 19(1):15-20.
[10]Barr JS. Ruptured intervertebral disc and sciatic pain. J Bone Joint Surg (Am), 1947, 29(2):429-437.
[11]Hakuba A. Trans-unco-discal approach. A combined anterior and lateral approach to cervical discs. J Neurosurg, 1976, 45(3):284-291.
[12]Jho HD. Microsurgical anterior cervical foraminotomy for radiculopathy: a new approach to cervical disc herniation. J Neurosurg, 1996, 84(2):155-160.
[13]Lesoin F, Biondi A, Jomin M. Foraminal cervical herniated disc treated by anterior discoforaminotomy. Neurosurgery, 1987, 21(3): 334-338.
[15]Snyder GM, Bernhardt M. Anterior cervical fractional interspace decompression for treatment of cervical radiculopathy. A review of the first 66 cases. Clin Orthop Relat Res, 1989, (246):92-99.
[16]Verbiest H. A lateral approach to the cervical spine: technique and indications. J Neurosurg, 1968, 28(3):191-203.
[17]Bartolomei JC, Theodore N, Sonntag VK. Adjacent level degeneration after anterior cervical fusion: a clinical review. Neurosurg Clin N Am, 2005, 16(4): 575-587.
[18]Fountas KN, Kapsalaki EZ, Nikolakakos LG, et al. Anterior cervical discectomy and fusion associated complications. Spine, 2007, 32(21):2310-2317.
[19]Hauerberg J, Kosteljanetz M, BФge-Rasmussen T, et al. Anterior cervical discectomy with or without fusion with ray titanium cage: a prospective randomized clinical study. Spine, 2008, 33(5):458-464.
[20]Konduru S, Findlay G. Anterior cervical discectomy: to graft or not to graft? Br J Neurosurg, 2009, 23(1):99-103.
[21]Nandoe Tewarie RD, Bartels RH, Peul WC. Long-term outcome after anterior cervical discectomy without fusion. Eur Spine J, 2007, 16(9):1411-1416.
[22]Oktenoglu T, Cosar M, Ozer AF, et al. Anterior cervical microdiscectomy with or without fusion. J Spinal Disord Tech, 2007, 20(5):361-368.
[23]Ruetten S, Komp M, Merk H, et al. Full-endoscopic cervical posterior foraminotomy for the operation of lateral disc herniations using 5.9-mm endoscopes: a prospective, randomized, controlled study. Spine, 2008, 33(9):940-948.
[24]Ruetten S, Komp M, Merk H, et al. Full-endoscopic anterior decompression versus conventional anterior decompression and fusion in cervical disc herniations. Int Orthop, 2009, 33(6):1677-1682.
[25]Donaldson JW, Nelson PB. Anterior cervical discectomy without interbody fusion. Surg Neurol, 2002, 57(4):219-224; discussion 224-225.
[26]Korinth MC, Krüger A, Oertel MF, et al. Posterior foraminotomy or anterior discectomy with polymethyl methacrylate interbody stabilization for cervical soft disc disease: results in 292 patients with monoradiculopathy. Spine, 2006, 31(11):1207-1214; discussion 1215-1216.
[27]Pechlivanis I, Brenke C, Scholz M, et al. Treatment of degenerative cervical disc disease with uncoforaminotomy—intermediate clinical outcome. Minim Invasive Neurosurg, 2008, 51(4):211-217.
[28]Liu KX, Massoud B. Endoscopic anterior cervical discectomy under epidurogram guidance. Surg Technol Int, 2010, 20:373-378.