Abstract
BackgroundPercutaneous spinal endoscopy is a new type of surgery for the treatment of cervical disc herniation. It can avoid the complications of the classic anterior cervical discectomy and fusion (ACDF) approach and the risk of adjacent spondylosis. How can we effectively improve patients’ awareness of spinal endoscopy and their election of endoscopic techniques?ObjectiveTo analyze the compliance and clinical effect of the integrated management of the whole process in the choice of percutaneous full-endoscopic surgery for patients with cervical disc herniation.MethodsRetrospective analysis of 72 patients with cervical disc herniation undergoing surgery in our hospital from August 2015–August 2017 was performed. The whole-process integrated management model was used for all the patients. The 36 patients in the experimental group were treated by percutaneous full-endoscopic cervical discectomy, and the 36 patients in the control group were treated by ACDF. The postoperative feeding time, time to get out of bed, length of hospital stay, compliance, clinical efficacy, and recurrence rate of neck pain were observed. Changes between the preoperative and postoperative pain visual analog scale (VAS) scores and neurological function Japan Orthopaedic Association (JOA) scores were assessed.ResultsThe postoperative feeding time in the experimental group was 8.319 ± 1.374 h, the postoperative time to get out of bed was 16.64 ± 3.728 h, and the hospitalization time was 6.403 ± 0.735 days. The excellent and good clinical efficacy rate was 91.67%, the compliance rate was 88.89%, and the neck pain recurrence rate was 5.56%. The postoperative feeding time in the control group was 26.56 ± 9.512 h, the postoperative time to get out of bed was 45.06 ± 9.027 h, and the length of hospital stay was 8.208 ± 0.865 days. The excellent and good clinical efficacy rate was 88.89%, the compliance rate was 69.4%, and the neck pain recurrence rate was 8.33%. There was no significant difference between the two groups in the excellent efficacy rate and the neck pain recurrence rate, p > 0.05. The compliance rate in the experimental group was better than that in the control group, and the difference was statistically significant, p < 0.05. The hospitalization time of the experimental group was significantly lower than that of the control group, and the difference was statistically significant, p < 0.05. The postoperative VAS scores and JOA scores of the two groups were significantly better than the preoperative scores, and the difference was statistically significant, p < 0.05; there was no significant difference between the two groups, p > 0.05.ConclusionThe integrated management of the whole course can effectively improve the compliance of patients with cervical disc herniation receiving endoscopic treatment, yield the same treatment effect as the classic operation, shorten the hospitalization time, speed up the turnover of hospital beds, and improve satisfaction with medical quality and is worthy of clinical application.
Highlights
Percutaneous spinal endoscopy is a new type of surgery for the treatment of cervical disc herniation
The postoperative visual analog scale (VAS) scores and Japan Orthopaedic Association (JOA) scores of the two groups were significantly better than the preoperative scores, and the difference was statistically significant, p < 0.05; there was no significant difference between the two groups, p > 0.05
Inclusion criteria (1) For patients with single-segment Cervical disc herniation (CDH), the symptoms and signs of the patients were consistent with the MRI examination; (2) the patient received systematic conservative treatment for more than 1 month, and the patient’s symptoms did not improve significantly or consistently; and (3) patients volunteered to participate in clinical observation, made an informed choice regarding the surgical plan, and were willing to cooperate with the clinical follow-up
Summary
Retrospective analysis of 72 patients with cervical disc herniation undergoing surgery in our hospital from August 2015–August 2017 was performed. The executive team implements CDH fixed bed management and provides basic information about the disease, including onset factors, treatment methods, surgical methods, treatment procedures, daily habits, and prevention and health care methods, according to the patient’s cognition [14, 15]. The integrated model involves evaluating the risks of surgery and anesthesia before surgery, eliminating the contraindications for surgery, implementing the three-level physician rounding system and preoperative discussion system, fully communicating with patients and their families, explaining the pros and cons of the two surgical options, and determining the surgical plan based on the patient’s informed understanding and willingness. The indications of anterior transcorporeal full-endoscopic decompression techniques are central and para-central cervical disc herniation. SPSS 22.0 statistical software, measurement data were expressed as the mean ± standard deviation (x±s), and comparisons between groups were performed by independent samples t tests; count data were tested by the X2 test, and P < 0.05 was considered statistically significant
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