Treatment of Cervical Spondylotic Radiculopathy with Posterior Percutaneous Endoscopic Cervical Discectomy

Abstract

Purpose Objective to investigate the safety and clinical efficacy of posterior percutaneous endoscopic discectomy (PPECD) in the treatment of cervical spondylotic radiculopathy (CSR). Method from January 2016 to December 2019, 35 cases of CSR were treated with PPECD. The degree of pain was evaluated by numeric rating scales (NRS) before operation, at discharge, 1 month, 3 months, 6 months, 1 year after operation and at the last follow-up. The functional recovery was evaluated by neck disability index (NDI) and Japanese orthopaedic association (JOA). The clinical efficacy was evaluated by modified MacNab grading and MRI at the last follow-up. Result of the 35 patients, 16 males and 19 females were aged 39~78 years, with an average age of (54.0 ± 9.9) years. The operative segments were C4-5 9, C5-6 15 and C6-7 11. All 35 patients successfully completed the operation. The operation time was 60~90min, the average time was (75.0 ± 7.9) min, the bleeding volume was 10~22ml, the average (16.3 ± 3.1) ml, the postoperative hospitalization days were 4~12 days, and the average was (7.0 ± 1.6) days. All 35 patients were followed up for more than one year after operation, with an average follow-up of 26.7 months (13~53 months). The NRS index was significantly lower in each period than before operation (P < 0.01), NDI and JOA index were significantly lower than those before operation (P < 0.01). The clinical effect was evaluated at the last follow-up, 20 cases were excellent, 12 were good, 3 were fine, and the excellent rate was 91.4%. No complications such as nerve root injury, dural sac tear or infection occurred during the follow-up period, and no patients needed to receive secondary minimally invasive or open surgery for symptom recurrence. Conclusion Under the premise of strictly grasping the indications, the curative effect of PPECD in the treatment of CSR is confirmed, and the patients' satisfaction is high.