Foraminal Stenosis With Radiculopathy From a Cervical Disc Herniation in a 33-Year-Old Man Treated With Flexion Distraction Decompression Manipulation

2008 ◽  
Vol 31 (5) ◽  
pp. 376-380 ◽  
Author(s):  
Sharina Gudavalli ◽  
Ralph A. Kruse
Keyword(s):  
Disc Herniation ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Foraminal Stenosis

scholarly journals Are Foraminal Stenosis Severity and Herniation Level Associated with the Treatment Success of Cervical Interlaminar Epidural Steroid Injection?

2020 ◽  
Vol 3;23 (6;3) ◽  
pp. 325-332
Author(s):  
Ipek Saadet Edipoglu
Keyword(s):  
Disc Herniation ◽  
Treatment Success ◽  
Radicular Pain ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Foraminal Stenosis ◽  
Spinal Level ◽  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
Epidural Steroid

Background: Foraminal stenosis, defined as a narrowing of the cervical neural foramen, is one of the most common causes of upper extremity radicular pain. Objectives: The aim of our study was to determine the effects of the severity of neural foraminal stenosis and spinal herniation level on treatment success in patients treated with interlaminar epidural steroid injections (ILESI) due to cervical disc herniation-related radiculopathy and their possible predictive roles. Study Design: A retrospective assessment. Setting: A university hospital interventional pain management center. Methods: We performed our study between August 2017 and February 2019, retrospectively. All patients’ demographic characteristics, clinical and demographic data, including pain scores before and after cervical ILESI in the first hour, third week, and third month follow-ups, presence of motor deficits, symptom side, symptom duration before cervical ILESI, and whether there was progression to surgery in the 3-month period after injection, were collected. Results: We evaluated 61 patients in the final analysis. When the spinal herniation levels and foraminal stenosis grades were compared, there was a significant difference between the groups (P = 0.003, P = 0.005). We reported significant correlations between foraminal stenosis grade (odds ratio [OR], –0.425, P = 0.038) and spinal herniation level (OR, –0.925, P = 0.001) and treatment success. Limitations: Our study’s design was retrospective. Conclusions: Cervical ILESI is a reliable treatment option that provides a significant reduction in pain of patients with cervical radiculopathy. However, the success of ILESI treatment may be negatively affected in these patients in the presence of high spinal level cervical disc herniation and severe foraminal stenosis. Therefore considering these 2 parameters in predicting the patient population who will benefit from cervical ILESI is of importance in terms of decreasing potential complications. Key words: Interlaminar epidural steroid injections, foraminal stenosis, spinal level, cervical disc herniation, radicular pain

scholarly journals Comparative Evaluation of Posterior Percutaneous Endoscopic Cervical Discectomy Using 3.7mm Endoscopic and 6.9mm Endoscopic for Cervical Disc Herniation: a retrospective comparative cohort study. 

2020 ◽  
Author(s):  
Tong Yu ◽  
Jiu-Ping Wu ◽  
Jun Zhang ◽  
Hai-Chi Yu ◽  
Qinyi Liu
Keyword(s):  
Spinal Cord ◽  
Clinical Outcomes ◽  
Disc Herniation ◽  
Large Diameter ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Foraminal Stenosis ◽  
Cervical Discectomy ◽  
Significant Difference ◽  
Cord Injury

Abstract Background. Posterior percutaneous endoscopic cervical discectomy (p-PECD) is an effective strategy for cervical diseases which working cannula ranges from 3.7 mm to 6.9 mm. However, no studies were performed to compare the clinical outcomes of endoscopes with different diameters in cervical disc herniation (CDH) patients. The purpose of this study was to compare the clinical outcomes of unilateral CDH patients treated with p-PECD applying the 3.7mm endoscopic with those treated with the 6.9mm endoscopic. Methods. From January 2016 to June 2018, totally 28 consecutive patients presented with single-level CDH who received p-PECD using the 3.7mm or the 6.9mm endoscopic were enrolled. The indications for this study were as follows: (1) Unilateral cervical spondylotic radiculopathy with pain irradiated to upper extremity, (2) MRI and CT scan show that foraminal CDH located lateral to the edge of spinal cord, from C4–C5 to C7–T1, (3) Unilateral symptoms caused by foraminal stenosis, (4) Failure after conservative treatment for at least 6 weeks or neurological symptoms aggravated. The clinical outcomes, including the operation time, the hospitalization, the visual analogue scale (VAS) and the modified MacNab criteria, were evaluated. Cervical fluoroscopy, CT, and MRI were performed during follow up.Results. The mean surgical duration of the 3.7mm endoscopic was 76.5 minutes compared with 61.5 minutes for 6.9mm endoscopic (P<0.05). Moreover, there was significant difference with regard to average identification time of “V” point (18.608±3.7607min vs. 11.256±2.7161min, p＜0.001) and mean removal time of overlying tissue (16.650±4.1730 min vs. 12.712±3.3079 min, p＜0.05) between 3.7mm endoscopic and 6.9mm endoscopic. The VAS and MacNab scores postoperatively of the two endoscopies were significantly improved compared with that before operation (p＜0.05).Conclusion. Both 3.7mm endoscopic and 6.9mm endoscopic are effective methods for CDH in selected patients, and there is no significant difference in clinical outcomes. 6.9mm endoscopic is superior to 3.7mm endoscopic in the efficiency of “V” point identification, overlying soft tissue removal and spinal cord injury prevention. Furthermore, 6.9mm endoscopy may be inferior to 3.7mm endoscopy in anterior decompression of foramina due to its large diameter, which needs to be further evaluated by a large number of randomized controlled trials.

scholarly journals Comparative Evaluation of Posterior Percutaneous Endoscopic Cervical Discectomy Using 3.7mm Endoscopic and 6.9mm Endoscopic for Cervical Disc Herniation: a retrospective comparative cohort study.

2020 ◽  
Author(s):  
Tong Yu ◽  
Jiu-Ping Wu ◽  
Jun Zhang ◽  
Hai-Chi Yu ◽  
Qinyi Liu
Keyword(s):  
Spinal Cord ◽  
Clinical Outcomes ◽  
Disc Herniation ◽  
Operation Time ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Foraminal Stenosis ◽  
Cervical Discectomy ◽  
Significant Difference ◽  
Cord Injury

Abstract Background. Posterior percutaneous endoscopic cervical discectomy (p-PECD) is an effective strategy for cervical diseases which working cannula ranges from 3.7 mm to 6.9 mm. However, no studies were performed to compare the clinical outcomes of endoscopes with different diameters in cervical disc herniation (CDH) patients. The purpose of this study was to compare the clinical outcomes of unilateral CDH patients treated with p-PECD applying the 3.7mm endoscopic with those treated with the 6.9mm endoscopic. Methods. From January 2016 to June 2018, totally 28 consecutive patients presented with single-level CDH who received p-PECD using the 3.7mm endoscopic or the 6.9mm endoscopic were enrolled. The indications for this study were as follows: (1) Unilateral cervical spondylotic radiculopathy with pain irradiated to upper extremity, (2) MRI and CT scan show that foraminal CDH located lateral to the edge of spinal cord, from C4–C5 to C7–T1, (3) Unilateral symptoms caused by foraminal stenosis, (4) Failure after conservative treatment for at least 6 weeks or neurological symptoms aggravated. Patients were evaluated neurologically pre- and postoperatively. The clinical outcomes, including the operation time, the hospitalization, the visual analogue scale (VAS) and the modified MacNab criteria, were evaluated. Cervical fluoroscopy, CT, and MRI were performed during follow up.Results. The mean surgical duration of the 3.7mm endoscopic was 76.5 minutes compared with 61.5 minutes for 6.9mm endoscopic (P<0.05). Moreover, there was significant difference with regard to average identification time of “V” point (18.608±3.7607min vs. 11.256±2.7161min, p＜0.001) and mean removal time of overlying tissue (16.650±4.1730 min vs. 12.712±3.3079 min, p＜0.05) between 3.7mm endoscopic and 6.9mm endoscopic. The VAS and MacNab scores postoperatively of the two endoscopies were significantly improved compared with that before operation (p＜0.05).Conclusion. Both 3.7mm endoscopic and 6.9mm endoscopic are effective methods for CDH in selected patients, and there is no significant difference in clinical outcomes. 6.9mm endoscopic is superior to 3.7mm endoscopic in the efficiency of “V” point identification, overlying soft tissue removal and spinal cord injury prevention. Furthermore, 6.9mm endoscopic is inferior to 3.7mm endoscopic in anterior decompression of the intervertebral foramen.

Cervical brucellar spondylodiscitis mimicking a cervical disc herniation with epidural abscess: a case report

2014 ◽  
Vol 0 (0) ◽  
Author(s):  
Ahmet Aslan ◽  
Ünal Kurtoğlu ◽  
Mustafa Özgür Akça ◽  
Sinan Tan ◽  
Uğur Soylu ◽  
...  
Keyword(s):  
Case Report ◽  
Disc Herniation ◽  
Epidural Abscess ◽  
Cervical Disc Herniation ◽  
Cervical Disc

scholarly journals Comparative evaluation of posterior percutaneous endoscopy cervical discectomy using a 3.7 mm endoscope and a 6.9 mm endoscope for cervical disc herniation: a retrospective comparative cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Tong Yu ◽  
Jiu-Ping Wu ◽  
Jun Zhang ◽  
Hai-Chi Yu ◽  
Qin-Yi Liu
Keyword(s):  
Clinical Outcomes ◽  
Disc Herniation ◽  
Large Diameter ◽  
Clinical Results ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Cervical Discectomy ◽  
Significant Difference ◽  
Cord Injury ◽  
Percutaneous Endoscopy

Abstract Background Posterior percutaneous endoscopy cervical discectomy (p-PECD) is an effective strategy for the treatment of cervical diseases, with a working cannula ranging from 3.7 mm to 6.9 mm in diameter. However, to date, no studies have been performed to compare the clinical outcomes of the use of endoscopes with different diameters in cervical disc herniation (CDH) patients. The purpose of this study was to compare the clinical outcomes of patients with unilateral CDH treated with p-PECD using a 3.7 mm endoscope and a 6.9 mm endoscope. Methods From January 2016 to June 2018, a total of 28 consecutive patients with single-level CDH who received p-PECD using either the 3.7 mm or the 6.9 mm endoscope were enrolled. The clinical results, including the surgical duration, hospitalization, visual analog scale (VAS) score and modified MacNab criteria, were evaluated. Cervical fluoroscopy, CT, and MRI were also performed during follow-up. Results Tthere was a significant difference in regard to the average identification time of the “V” point (18.608 ± 3.7607 min vs. 11.256 ± 2.7161 min, p < 0.001) and the mean removal time of the overlying tissue (16.650 ± 4.1730 min vs. 12.712 ± 3.3079 min, p < 0.05) for the use of the 3.7 mm endoscope and the 6.9 mm endoscope, respectively. The postoperative VAS and MacNab scores of the two endoscopes were significantly improved compared with those the preoperative scores (p < 0.05). Conclusion The application of both the 3.7 mm endoscope and 6.9 mm endoscope represent an effective method for the treatment of CDH in selected patients, and no significant difference can be observed in the clinical outcomes of the endoscopes. The 6.9 mm endoscope shows superiority to the 3.7 mm endoscope in terms of the efficiency of “V” point identification, the removal of overlying soft tissue and the prevention of spinal cord injury. However, the 6.9 mm endoscope may be inferior to the 3.7 mm endoscope in regards to anterior foraminal decompression due to its large diameter; this result needs to be further evaluated with the support of a large number of randomized controlled trials.

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