Comment on "Effective Range of Percutaneous Posterior Full-Endoscopic Paramedian Cervical Disc Herniation Discectomy and Indications for Patient Selection".

Jun-Song Yang,Lei Chu,Hao Chen,Ding-Jun Hao,Peng Liu

doi:10.1155/2020/3548194

Jun-Song Yang, Lei Chu + Show 3 more

Open Access

https://doi.org/10.1155/2020/3548194

Copy DOI

Abstract

The objective was to investigate the effective and safe range of paramedian CDH by percutaneous posterior full-endoscopy cervical intervertebral disc nucleus pulposus resection (PPFECD) to provide a reference for indications and patient selection. Sixteen patients with CDH satisfied the inclusion criteria. Before surgery the patients underwent cervical spine MRI, and the distance between the dural sac and herniated disc was measured. An assessment was performed by MRI immediately after surgery, measuring the distance between dural sac and medial border of discectomy (DSMD). The preoperative average distance between the dural sac and peak of the herniated disc (DSPHD) was 3.87 ± 1.32 mm; preoperative average distance between dural sac and medial border of herniated disc (DSMHD) was 6.91 ± 1.21 mm and an average distance of postoperative DSMD was 5.41 ± 1.40 mm. Postoperative VAS of neck and shoulder pain was significantly decreased but JOA was significantly increased in each time point compared with preoperative ones. In summary, the effective range of PPFECD to treat paramedian CDH was 5.41 ± 1.40 mm, indicating that DSMHD and DSPHD were within 6.91 ± 1.21 mm and 3.87 ± 1.32 mm, respectively. PPFECD surgery is, therefore, a safe and effective treatment option for patients with partial paramedian cervical disc herniation.

Highlights

To the patients with huge paramedian cervical disc herniation, the lateral border of the dural sac usually becomes obscured (Figure 1), which could not be and accurately delineated as shown in the figure. e medial margin of the uncovertebral joint seems to be more appropriate
We would like to congratulate the authors for their interesting paper, but we would like to make some comments because we are a little bit concerned with the measurement method they apply to define the vertical distance between the lateral border of the dural sac and the peak of the herniated disc (DSPHD); the vertical distance between the lateral border of the dural sac and the intersection of the dural sac and the medial border of the herniated disc (DSMHD); and the vertical distance between the lateral border of the dural sac and the intersection of the dural sac and the medial border of discectomy (DSMD)
DSMD is measured based on the magnetic resonance imaging (MRI) at 3 days after surgery

Summary

Introduction

To the patients with huge paramedian cervical disc herniation, the lateral border of the dural sac usually becomes obscured (Figure 1), which could not be and accurately delineated as shown in the figure. e medial margin of the uncovertebral joint seems to be more appropriate (red arrow). We would like to congratulate the authors for their interesting paper, but we would like to make some comments because we are a little bit concerned with the measurement method they apply to define the vertical distance between the lateral border of the dural sac and the peak of the herniated disc (DSPHD); the vertical distance between the lateral border of the dural sac and the intersection of the dural sac and the medial border of the herniated disc (DSMHD); and the vertical distance between the lateral border of the dural sac and the intersection of the dural sac and the medial border of discectomy (DSMD). To the patients with huge paramedian cervical disc herniation, the lateral border of the dural sac usually becomes obscured (Figure 1), which could not be and accurately delineated as shown in the figure.

Results

Conclusion