Percutaneous Endoscopic Posterior Lateral Approach for the Treatment of Central Cervical Disc Herniation

Abstract

To design percutaneous endoscopic surgery via a posterolateral approach for the treatment of central cervical disc herniation. From October 2019 to October 2020, 12 consecutive patients with central cervical disc herniation underwent percutaneous endoscopic posterior lateral cervical surgery. The imaging examination (dynamic X-ray, computed tomography, and magnetic resonance imaging of the cervical spine) was conducted after the operation. Visual analog scale score and the modified Japanese Orthopaedic Association score was performed before and after the operation. Twelve patients (6 men and 6 women; mean age 52.08±9.3years) were included, and the average operation time was 105.00±10.55minutes. Postoperative computed tomography and magnetic resonance imaging results showed that the treatment segment of all patients was prominent, the cervical intervertebral disc was completely removed, the cervical spinal cord was fully decompressed, and there were no cases of infection, cerebrospinal fluid leakage or neurological complications. The average follow-up time after the operation was 22.83±3.13months. One year after the operation, there was no cervical instability in the X-ray examination of cervical flexion and extension position. Preoperative visual analog scale score and the modified Japanese Orthopaedic Association score were significantly improved at the last follow-up. Percutaneous endoscopic posterior lateral cervical discectomy provides a new surgical method for the endoscopic treatment of central cervical disc herniation. This treatment has a better surgical field and easier operation, which can remove the protruding cervical disc under the endoscope and make sure that the cervical spinal cord is fully decompressed. The clinical effect is satisfactory. A small amount of pedicle resection will not cause cervical instability.