Abstract
BackgroundACDF is the standard procedure for treatment of cervical spondylotic myelopathy (CSM), but a long-term follow-up has been revealed some associated complications of swallowing discomfort, displacement of the fusion device, and accelerated degeneration of the adjacent segment.ObjectiveTo evaluate the clinical outcomes of anterior percutaneous full-endoscopic transcorporeal decompression of the spinal cord (APFETDSC) for single-segment CSM and to analyze the clinical efficacy, surgical characteristics, and complication prevention.MethodsA total of 32 patients who underwent APFETDSC for single-segment CSM from Aug. 2015 to Apr. 2017 were reviewed. Operating time, time of walking out of bed postoperation, length of hospitalization, complications, neck pain visual analog scale (VAS), and Japanese Orthopaedic Association Score (JOA) were evaluated. Measurement of intervertebral height (HI) of surgical segments on cervical neutral X-ray, Harrison’s method was used to measure cervical spine angle (CSA).ResultsThe operation time was 103.3 ± 12.95 min, time of walking out of bed after surgery was 19.81 ± 4.603 h, the length of postoperative hospital stay was 57.48 ± 19.48 h. The postoperative neck pain VAS and JOA were significantly improved compared with preoperation(p < 0.001). The postoperative HI was statistical significance decreased compared with preoperation(p < 0.001), but the HI reduction was less than 0.5 mm, without adverse clinical symptoms. The postoperative CSA was significantly improved compared with preoperative(p < 0.001). The excellent and good rate was 87.5%, and the JOA improvement rate was 75.52 ± 11.11%. There was no cervical instability, vertebral fracture, wound infection, and other complications.ConclusionsAPFETDSC is a safe and effective minimally invasive technique with small auxiliary injuries for single-segment CSM while avoiding the sequelae of ACDF. Its short-term clinical efficacy was good and no significant effect on cervical stability.
Highlights
Cervical spondylotic myelopathy (CSM) is a series of clinical symptoms and signs that result from cervical spine degeneration and compression of the spinal cord, and patients are primarily characterized by numbness in the upper extremities or lower limbs, thoracic fasciculation, clumsy hands, feelings of walking on cotton, and even sphincter dysfunction [1]
We reported a cohort study using percutaneous full-endoscopic transcorporeal cervical discectomy [14]
This procedure focuses on soft prominent disc tissue, which does not elucidate in effective decompression of the spinal cord by discosteophytes, with the further application of spinal endoscopy in the treatment of cervical spondylosis
Summary
Cervical spondylotic myelopathy (CSM) is a series of clinical symptoms and signs that result from cervical spine degeneration and compression of the spinal cord, and patients are primarily characterized by numbness in the upper extremities or lower limbs, thoracic fasciculation, clumsy hands, feelings of walking on cotton, and even sphincter dysfunction [1]. Spinal endoscopy has been widely used in the treatment of lumbar degenerative diseases, and endoscopic surgery for cervical degeneration diseases is a hotspot in spine surgery [7,8,9]. We reported a cohort study using percutaneous full-endoscopic transcorporeal cervical discectomy [14]. This procedure focuses on soft prominent disc tissue, which does not elucidate in effective decompression of the spinal cord by discosteophytes, with the further application of spinal endoscopy in the treatment of cervical spondylosis. ACDF is the standard procedure for treatment of cervical spondylotic myelopathy (CSM), but a longterm follow-up has been revealed some associated complications of swallowing discomfort, displacement of the fusion device, and accelerated degeneration of the adjacent segment
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