Percutaneous endoscopic cervical discectomy for ruptured cervical disc herniation: clinical results and radiological analysis at a minimum 2 years follow-up

2010 ◽  
Vol 22 (3) ◽  
pp. 113-117
Author(s):  
Sung Min Hur ◽  
Sang-Ho Lee ◽  
Won-Chul Choi ◽  
Youngshin Rho
Keyword(s):  
Disc Herniation ◽  
Clinical Results ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Cervical Discectomy ◽  
Radiological Analysis

scholarly journals Comparative evaluation of posterior percutaneous endoscopy cervical discectomy using a 3.7 mm endoscope and a 6.9 mm endoscope for cervical disc herniation: a retrospective comparative cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Tong Yu ◽  
Jiu-Ping Wu ◽  
Jun Zhang ◽  
Hai-Chi Yu ◽  
Qin-Yi Liu
Keyword(s):  
Clinical Outcomes ◽  
Disc Herniation ◽  
Large Diameter ◽  
Clinical Results ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Cervical Discectomy ◽  
Significant Difference ◽  
Cord Injury ◽  
Percutaneous Endoscopy

Abstract Background Posterior percutaneous endoscopy cervical discectomy (p-PECD) is an effective strategy for the treatment of cervical diseases, with a working cannula ranging from 3.7 mm to 6.9 mm in diameter. However, to date, no studies have been performed to compare the clinical outcomes of the use of endoscopes with different diameters in cervical disc herniation (CDH) patients. The purpose of this study was to compare the clinical outcomes of patients with unilateral CDH treated with p-PECD using a 3.7 mm endoscope and a 6.9 mm endoscope. Methods From January 2016 to June 2018, a total of 28 consecutive patients with single-level CDH who received p-PECD using either the 3.7 mm or the 6.9 mm endoscope were enrolled. The clinical results, including the surgical duration, hospitalization, visual analog scale (VAS) score and modified MacNab criteria, were evaluated. Cervical fluoroscopy, CT, and MRI were also performed during follow-up. Results Tthere was a significant difference in regard to the average identification time of the “V” point (18.608 ± 3.7607 min vs. 11.256 ± 2.7161 min, p < 0.001) and the mean removal time of the overlying tissue (16.650 ± 4.1730 min vs. 12.712 ± 3.3079 min, p < 0.05) for the use of the 3.7 mm endoscope and the 6.9 mm endoscope, respectively. The postoperative VAS and MacNab scores of the two endoscopes were significantly improved compared with those the preoperative scores (p < 0.05). Conclusion The application of both the 3.7 mm endoscope and 6.9 mm endoscope represent an effective method for the treatment of CDH in selected patients, and no significant difference can be observed in the clinical outcomes of the endoscopes. The 6.9 mm endoscope shows superiority to the 3.7 mm endoscope in terms of the efficiency of “V” point identification, the removal of overlying soft tissue and the prevention of spinal cord injury. However, the 6.9 mm endoscope may be inferior to the 3.7 mm endoscope in regards to anterior foraminal decompression due to its large diameter; this result needs to be further evaluated with the support of a large number of randomized controlled trials.

scholarly journals Comparative Evaluation of Posterior Percutaneous Endoscopy Cervical Discectomy Using 3.7 mm Endoscope and 6.9 mm Endoscope for Cervical Disc Herniation: a retrospective comparative cohort study

2021 ◽  
Author(s):  
Tong Yu ◽  
Jiu-Ping Wu ◽  
Jun Zhang ◽  
Hai-Chi Yu ◽  
Qinyi Liu
Keyword(s):  
Clinical Outcomes ◽  
Disc Herniation ◽  
Large Diameter ◽  
Clinical Results ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Cervical Discectomy ◽  
Significant Difference ◽  
Cord Injury ◽  
Percutaneous Endoscopy

Abstract Background. Posterior percutaneous endoscopy cervical discectomy (p-PECD) is an effective strategy for the treatment of cervical diseases, with a working cannula ranging from 3.7 mm to 6.9 mm in diameter. However, to date, no studies have been performed to compare the clinical outcomes of the use of endoscopes with different diameters in cervical disc herniation (CDH) patients. The purpose of this study was to compare the clinical outcomes of patients with unilateral CDH treated with p-PECD using a 3.7 mm endoscope and a 6.9 mm endoscope.Methods. From January 2016 to June 2018, a total of 28 consecutive patients with single-level CDH who received p-PECD using either the 3.7 mm or the 6.9 mm endoscope were enrolled. The clinical results, including the surgical duration, hospitalization, visual analog scale (VAS) score and modified MacNab criteria, were evaluated. Cervical fluoroscopy, CT, and MRI were also performed during follow-up.Results. Tthere was a significant difference in regard to the average identification time of the “V” point (18.608±3.7607 min vs. 11.256±2.7161 min, p<0.001) and the mean removal time of the overlying tissue (16.650±4.1730 min vs. 12.712±3.3079 min, p<0.05) for the use of the 3.7 mm endoscope and the 6.9 mm endoscope, respectively. The postoperative VAS and MacNab scores of the two endoscopes were significantly improved compared with those the preoperative scores (p<0.05).Conclusion. The application of both the 3.7 mm endoscope and 6.9 mm endoscope represent an effective method for the treatment of CDH in selected patients, and no significant difference can be observed in the clinical outcomes of the endoscopes. The 6.9 mm endoscope shows superiority to the 3.7 mm endoscope in terms of the efficiency of “V” point identification, the removal of overlying soft tissue and the prevention of spinal cord injury. However, the 6.9 mm endoscope may be inferior to the 3.7 mm endoscope in regards to anterior foraminal decompression due to its large diameter; this result needs to be further evaluated with the support of a large number of randomized controlled trials.

scholarly journals Surgery in cervical disc herniation: anterior cervical discectomy without fusion or with fusion

2017 ◽  
Vol 31 (1) ◽  
pp. 54-58
Author(s):  
Andrei Stefan Iencean
Keyword(s):  
Range Of Motion ◽  
Disc Herniation ◽  
Clinical Results ◽  
Small Degree ◽  
Anterior Cervical Discectomy ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Cervical Discectomy ◽  
Single Level ◽  
Anteroposterior Translation

Abstract The study included a group of anterior cervical microdiscectomy without fusion performed at one level (either C5-C6 level or at the C6-C7 level) and a second group of patients with same single-level of anterior cervical discectomy with fusion. The kinematic analysis included the range of motion, anteroposterior translation and disc height assessed for the cervical functional spinal units at the operated level and adjacent levels. At the operated level the range of motion and the translation were minimal in the anterior cervical discectomy without fusion group, both for the C5-C6 and C6-C7 levels, and absent in the cervical discectomy with fusion group. The superior adjacent levels translations were greater in the ACDF group compared with the ACD group. The clinical results of both types of cervical discectomy were comparable. In cervical microdiscectomy without fusion the elastic fibrous intradiscal scar at the operated level allows a small degree of mobility and the adjacent cervical levels are not overstressed. No need for anterior cervical discectomy with fusion to trait a single level cervical disc herniation than in selected cases.

scholarly journals Comparative Evaluation of Posterior Percutaneous Endoscopy Cervical Discectomy Using 3.7 mm Endoscope and 6.9 mm Endoscope for Cervical Disc Herniation: a retrospective comparative cohort study

2020 ◽  
Author(s):  
Tong Yu ◽  
Jiu-Ping Wu ◽  
Jun Zhang ◽  
Hai-Chi Yu ◽  
Qinyi Liu
Keyword(s):  
Clinical Outcomes ◽  
Disc Herniation ◽  
Large Diameter ◽  
Clinical Results ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Cervical Discectomy ◽  
Significant Difference ◽  
Cord Injury ◽  
Percutaneous Endoscopy

Abstract Background. Posterior percutaneous endoscopy cervical discectomy (p-PECD) is an effective strategy for the treatment of cervical diseases, with a working cannula ranging from 3.7 mm to 6.9 mm in diameter. However, to date, no studies have been performed to compare the clinical outcomes of the use of endoscopes with different diameters in cervical disc herniation (CDH) patients. The purpose of this study was to compare the clinical outcomes of patients with unilateral CDH treated with p-PECD using a 3.7 mm endoscope and a 6.9 mm endoscope.Methods. From January 2016 to June 2018, a total of 28 consecutive patients with single-level CDH who received p-PECD using either the 3.7 mm or the 6.9 mm endoscope were enrolled. The clinical results, including the surgical duration, hospitalization, visual analog scale (VAS) score and modified MacNab criteria, were evaluated. Cervical fluoroscopy, CT, and MRI were also performed during follow-up.Results. Tthere was a significant difference in regard to the average identification time of the “V” point (18.608±3.7607 min vs. 11.256±2.7161 min, p<0.001) and the mean removal time of the overlying tissue (16.650±4.1730 min vs. 12.712±3.3079 min, p<0.05) for the use of the 3.7 mm endoscope and the 6.9 mm endoscope, respectively. The postoperative VAS and MacNab scores of the two endoscopes were significantly improved compared with those the preoperative scores (p<0.05).Conclusion. The application of both the 3.7 mm endoscope and 6.9 mm endoscope represent an effective method for the treatment of CDH in selected patients, and no significant difference can be observed in the clinical outcomes of the endoscopes. The 6.9 mm endoscope shows superiority to the 3.7 mm endoscope in terms of the efficiency of “V” point identification, the removal of overlying soft tissue and the prevention of spinal cord injury. However, the 6.9 mm endoscope may be inferior to the 3.7 mm endoscope in regards to anterior foraminal decompression due to its large diameter; this result needs to be further evaluated with the support of a large number of randomized controlled trials.

Implantation of an empty carbon fiber composite frame cage after single-level anterior cervical discectomy in the treatment of cervical disc herniation: preliminary results

2003 ◽  
Vol 98 (2) ◽  
pp. 143-147 ◽  
Author(s):  
Michael Payer ◽  
Daniel May ◽  
Alain Reverdin ◽  
Enrico Tessitore
Keyword(s):  
Disc Herniation ◽  
Fiber Composite ◽  
Anterior Cervical Discectomy ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Carbon Fiber Composite ◽  
Content Type ◽  
Cervical Discectomy ◽  
Fine Print

Object. The authors sought to evaluate retrospectively the radiological and clinical outcome of anterior cervical discectomy followed by implantation of an empty carbon fiber composite frame cage (CFCF) in the treatment of patients with cervical disc herniation and monoradiculopathy. Methods. Twenty-five consecutive patients (12 men, 13 women, mean age 45 years) with monoradiculopathy due to cervical disc herniation were treated by anterior cervical discectomy followed by implantation of an empty CFCF cage. On lateral flexion—extension radiographs segmental stability at a mean follow up of 14 months (range 5–31 months) was demonstrated in all 25 patients, and bone fusion was documented in 24 of 25 patients. The mean anterior intervertebral body height was 3.4 mm preoperatively and 3.8 mm at follow up in 20 patients. In these patients the mean segmental angle (angle between lower endplate of lower and upper vertebra) was 0.9° preoperatively and 3.1° at follow up. In the remaining five patients preoperative images were not retrievable. Self-scored neck pain based on a visual analog scale (1, minimum; 10, maximum) changed from a preoperative average of 5.6 to an average of 2 at follow up; radicular pain was reduced from 7.7 to 2.1 postoperatively. Analysis of the SF12 questionnaires showed a significant improvement in both the physical capacity score (preoperative mean 32.4 points; follow up 46 points) and the mental capacity score (preoperative mean 45.8 points; follow up 57.5 points). Conclusions. Implantation of an empty CFCF cage in the treatment of cervical disc herniation and monoradiculopathy avoids donor site morbidity associated with autologous bone grafting as well as the use of any supplementary material inside the cage. Restoration or maintenance of intervertebral height and thus segmental lordosis and a very high rate of segmental stability and fusion are achieved using this technique.

scholarly journals Percutaneous Full-Endoscopic Anterior Transcorporeal Cervical Discectomy for the Treatment of Cervical Disc Herniation: Surgical Design and Results

2021 ◽  
Vol 24 (6) ◽  
pp. E811-E819
Keyword(s):  
Clinical Efficacy ◽  
Study Design ◽  
Disc Herniation ◽  
Small Sample ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Disc Protrusion ◽  
Average Hospital ◽  
Cervical Discectomy

BACKGROUND: Studies that focus on percutaneous full-endoscopic anterior transcorporeal cervical discectomy (PEATCD) have rarely been reported. Therefore, the available data on the surgical design of PEATCD and related clinical outcomes are very limited. OBJECTIVES: To design a surgical plan for PEATCD and to evaluate its clinical efficacy in clinical application. STUDY DESIGN: A retrospective cohort study. SETTING: A center for spine surgery, rehabilitation department and pain medicine. METHODS: Based on the size and precise location of the disc protrusions on magnetic resonance imaging (MRI), the diameter and direction of the bone channel were designed to make a surgical plan for PEATCD. A total of 26 patients with central/paracentral cervical disc herniation (CDH) who underwent PEATCD through the designed surgical plan from October 2015 to September 2016 were enrolled in the retrospective study. Clinical outcome evaluations included Visual Analog Scale (VAS) scores, Japanese Orthopedic Association (JOA) scores, and the modified Macnab criteria. Radiologic follow-up included cervical computerized tomography (CT) and MRI evaluations. RESULTS: The diameter of the designed bone channel was about 7.5 mm, and the direction was from the upper edge of the lower endplate obliquely toward the disc protrusion. Through the designed surgical plan, 26 cases of discectomy were successfully completed. The average operation time was 91.50 ± 16.80 min, and the average hospital stay was 4.07 ± 0.84 days. All patients were followed for an average of 19.61 ± 4.04 months. The postoperative VAS and JOA scores were significantly improved compared with the preoperative scores (P < 0.0001). Clinical efficacy at the final follow-up was evaluated by the modified Macnab criteria, and the excellent and good rate was 92.31%. Postoperative MRI showed that the disc protrusion was completely removed, and CT showed no collapse of the vertebral body. LIMITATIONS: This study has several limitations, including the lack of a control group, the small sample size, and the unavoidable nature of the single-center study design. CONCLUSIONS: Based on the size and location of the disc protrusion on MRI, the diameter and direction of the bone channel are designed, which is conducive to have enough space under the full-endoscopic field of view to completely expose and remove the disc protrusion, to avoid residuals, and to ensure that PEATCD achieves good therapeutic results. Trial registration: The study was registered at Chinese Clinical Trial Registry (ChiCTR1900027820). KEY WORDS: Percutaneous full-endoscope, anterior transcorporeal approach, cervical discectomy, cervical disc herniation, minimally invasive surgery

scholarly journals Comparative Evaluation of Posterior Percutaneous Endoscopy Cervical Discectomy Using 3.7 mm Endoscope and 6.9 mm Endoscope for Cervical Disc Herniation: a retrospective comparative cohort study

2021 ◽  
Author(s):  
Tong Yu ◽  
Jiu-Ping Wu ◽  
Jun Zhang ◽  
Hai-Chi Yu ◽  
Qinyi Liu
Keyword(s):  
Clinical Outcomes ◽  
Disc Herniation ◽  
Large Diameter ◽  
Clinical Results ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Cervical Discectomy ◽  
Significant Difference ◽  
Cord Injury ◽  
Percutaneous Endoscopy

Abstract Background. Posterior percutaneous endoscopy cervical discectomy (p-PECD) is an effective strategy for the treatment of cervical diseases, with a working cannula ranging from 3.7 mm to 6.9 mm in diameter. However, to date, no studies have been performed to compare the clinical outcomes of the use of endoscopes with different diameters in cervical disc herniation (CDH) patients. The purpose of this study was to compare the clinical outcomes of patients with unilateral CDH treated with p-PECD using a 3.7 mm endoscope and a 6.9 mm endoscope.Methods. From January 2016 to June 2018, a total of 28 consecutive patients with single-level CDH who received p-PECD using either the 3.7 mm or the 6.9 mm endoscope were enrolled. The clinical results, including the surgical duration, hospitalization, visual analog scale (VAS) score and modified MacNab criteria, were evaluated. Cervical fluoroscopy, CT, and MRI were also performed during follow-up.Results. Tthere was a significant difference in regard to the average identification time of the “V” point (18.608±3.7607 min vs. 11.256±2.7161 min, p<0.001) and the mean removal time of the overlying tissue (16.650±4.1730 min vs. 12.712±3.3079 min, p<0.05) for the use of the 3.7 mm endoscope and the 6.9 mm endoscope, respectively. The postoperative VAS and MacNab scores of the two endoscopes were significantly improved compared with those the preoperative scores (p<0.05).Conclusion. The application of both the 3.7 mm endoscope and 6.9 mm endoscope represent an effective method for the treatment of CDH in selected patients, and no significant difference can be observed in the clinical outcomes of the endoscopes. The 6.9 mm endoscope shows superiority to the 3.7 mm endoscope in terms of the efficiency of “V” point identification, the removal of overlying soft tissue and the prevention of spinal cord injury. However, the 6.9 mm endoscope may be inferior to the 3.7 mm endoscope in regards to anterior foraminal decompression due to its large diameter; this result needs to be further evaluated with the support of a large number of randomized controlled trials.

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