Anterior Transcorporeal Approach to Percutaneous Endoscopic Cervical Diskectomy for Single-Level Cervical Intervertebral Disk Herniation: Case Series with 2-Year Follow-Up

Abstract

To examine the effects of anterior transcorporeal percutaneous endoscopic cervical diskectomy (ATPECD) for the treatment of single-level cervical intervertebral disk herniation (CIDH) with a focus on its safety, feasibility, clinical efficacy, and specific possible complications. A series of 35 patients with symptomatic single-level CIDH were enrolled to be treated with ATPECD. Neck and arm pain was measured using the visual analog scale. Quality of life was measured using the bodily pain and physical function on the SF-36. The average disk height and vertical vertebral body height were recorded. Bone healing was evaluated on the basis of postoperative computed tomography. Successful removal of the herniated disk was confirmed in all 35 cases. At 2 years, the patients showed a significant treatment effect in the visual analog scale and body pain and physical function portions of the SF-36 (1.14 ± 0.60 vs. 7.62 ± 0.61, 63.92 ± 6.74 vs. 32.55 ± 6.80, and 82.14 ± 6.22 vs. 34.43 ± 4.50, respectively, P < 0.01). Mean preoperative disk height was 6.79 ± 0.37 mm, which decreased to 6.34 ± 0.46 mm 2 years post operation (6.6% decrease). Preoperative surgical vertebral body height also decreased from preoperation (15.79 ± 0.52 mm) to 2 years post operation (15.12 ± 0.38 mm) (4.2% decrease). Three surgery-related complications were observed (8.6%). Preliminary clinical experience with ATPECD shows that it is safe, effective, feasible, and minimally invasive. Although it has some disadvantages, such as the need for repeated fluoroscopy, some minor complications, and nonsymptomatic disk height decreases, ATPECD can supplement minimally invasive surgeries in selected cases of CIDH.