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KMID : 1040920180030020047
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Journal of Minimally Invasive Spine Surgery and Technique
2018 Volume.3 No. 2 p.47 ~ p.51
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Anterior Percutaneous Endoscopic Cervical Discectomy, a Stitchless and Bloodless Surgery: Clinical and Radiological Results
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Nadkarni Sunil M
Sonawane Sumeet Kautik
Gore Satishchandra
Kohli Pawankumar
Varunjikar Muralidhar
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Abstract
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Objective: Anterior cervical discectomy with fusion [ACDF] has been considered gold standard for cervical disc herniation over period of time. Anterior percutaneous endoscopic cervical discectomy [PECD] is minimally invasive technique without need for implant or bone graft in properly selected cases. In this study we present clinical and radiological results of anterior PECD.
Methods: We retrospectively studied 31 patients treated with anterior PECD in our institute from January 2014 to December 2016. Patients’ clinical data, visual analogue score [VAS], neck disability index [NDI] and radiographs were collected. Cervical lordosis angle, focal angle and disc height of involved segment were measured using Medsynapse software. Statistical analysis was performed using paired T test, chi square test.
Results: There were 18 males, 13 females in this study. Mean follow up period was 28.5 months. VAS for neck pain reduced from 6.2±0.72 to 1.67±0.59; VAS for arm pain reduced from 7.25±0.71 to 1.5±0.61 at final follow up. NDI reduced from 64.7±7.62 to 13.48±5.42 at final follow up. Mean disc height of involved segment was 6.15 mm pre-operatively which reduced to 5.24 mm at final follow up showing reduction of 0.91 mm. This reduction is disc space is not clinically significant as VAS and NDI show significant fall. Cervical lordosis was well maintained which changed from 13.93°±3.7° to 15.58°±6.66°; [p-value is 0.060]. Pre-operative focal cervical angle of involved segment was 0.86°±1.66° which increased to 1.7°±1.81° at final follow up [p-value 0.0067]. Twenty out of 31 patients resumed their previous employment within 2 weeks.
Conclusion: Anterior PECD is excellent minimally invasive technique for cervical disc herniation in properly selected cases. Patients have good functional and clinical recovery after this procedure.
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KEYWORD
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Cervical discectomy, Endoscopic cervical discectomy, Minimally invasive spine surgery, Percutaneous endoscopic cervical discectomy, Cervical radiculopathy
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