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World Neurosurg. 2018 Apr;112:e23-e30. doi: 10.1016/j.wneu.2017.12.001. Epub 2017 Dec 11.

Percutaneous Full-Endoscopic Anterior Transcorporeal Procedure for Cervical Disc Herniation: A Novel Procedure and Early Follow-Up Study.

Author information

1
Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.
2
Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; Translational Research Institute, School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
3
Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
4
Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
5
Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China. Electronic address: wenbo900@sina.com.

Abstract

OBJECTIVE:

To describe the surgical technique of percutaneous full-endoscopic anterior transcorporeal cervical discectomy (PEATCD) in detail and report the clinical outcomes and radiologic changes in patients with cervical intervertebral disc herniation (CIVDH).

METHODS:

A novel procedure, PEATCD, was performed on 36 patients with CIVDH between June 2015 and June 2016. A retrospective study of these patients was carried out over a follow-up period of 12-24 months. The visual analog scale scores, Japanese Orthopedic Association (JOA) scores, and improvement rates (IRs) of the JOA scores were used to evaluate neurologic symptoms. Radiologic follow-up included magnetic resonance imaging, computed tomography scan, and standard radiographs.

RESULTS:

All patients reported immediate postoperative relief of neck and arm pain compared with the recorded preoperative levels of discomfort, and the JOA scores improved gradually during the follow-up period. The IRs of the neurologic evaluations ranged from 60% to 100%, the average being 85.47% ± 9.32%. The decrease in the intervertebral disc height was statistically significant (P < 0.0001), and there were no adverse clinically related symptoms. No collapse of the drilled vertebrae was recorded, and the bone defects showed significant decreases within 3 months after the operation. There were no surgery-related complications.

CONCLUSIONS:

PEATCD combines the benefits of an anterior transcorporeal approach with endoscopy, preserves the cervical motion segment and causes less damage to the disc, and significantly decreases surgical trauma. Therefore, PEATCD is a safe, effective, minimally invasive, alternative procedure for patients with CIVDH.

KEYWORDS:

Cervical discectomy; Cervical intervertebral disc herniation; Minimally invasive surgery; Percutaneous full endoscope; Transcorporeal approach

PMID:
29241695
DOI:
10.1016/j.wneu.2017.12.001
[Indexed for MEDLINE]

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