Clinical outcomes of posterior percutaneous endoscopic cervical discectomy for single level cervical spondylotic radiculopathy

Abstract

Objective To investigate the clinical outcomes using posterior percutaneous endoscopic cervical discectomy (PECD) for single level cervical spondylotic radiculopathy (CSR). Methods From October 2015 to June 2016, 33 patients (23 men, 10 women, mean age 54.0 years, range from 30 to 85 years) who had single level CSR were treated by PECD, and the medical records were reviewed. All patients were followed up for an average of 13.5±4.6 months (range from 12 to 22 months). The operation related parameters (operation time, estimated blood loss, length of hospitalization, complications) and clinical parameters, including neck visual analog scale (Neck-VAS), arm visual analog scale (Arm-VAS), neck disability index (NDI) and the modified Macnab criteria were assessed at 3, 6, and 12 months postoperatively and last follow-up. Disc height, shell angle, C2-C7 Cobb angle and range of motion were recorded preoperatively and at 3 months, 6 months, 12 months and last follow-up postoperatively. Results The mean operation time was 76.4±26.6 minutes (range from 40 to 120 minutes), the mean estimated blood loss was 30.2±15.6 ml (range from 20 to 80 ml), and the mean length of hospitalization was 3.5±1.1 days (range from 2 to 8 days). There was significant decrease at different time points postoperatively in Neck-VAS, Arm-VAS, and NDI when compared with preoperatively (P 0.05). One patient turned into traditional ACDF procedure because of hemorrhage limiting the vision during PECD operation. Upper extremity numbness and pain deteriorated in one case after a PECD procedure and was revised with ACDF at last. No other complications, like spinal cord injury, cervical root injury, cerebral spinal fluid leakage, infection as well as recurrence were found. Conclusion PECD, which can maintain normal cervical range of motion and intervertebral disc height, is a minimally invasive and essential procedure for CSR treatment with minor trauma, excellent outcome and quick recovery. Surgeon's experience, however, is needed in case of turning into open surgery for good outcome. Key words: Cervical vertebrae; Intervertebral disc displacement; Endoscopy; Surgical procedures, minimally invasive