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

2021 ◽  
Author(s):  
Tong Yu ◽  
Jiu-Ping Wu ◽  
Jun Zhang ◽  
Hai-Chi Yu ◽  
Qinyi 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.

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.

scholarly journals Comparative Evaluation of Posterior Percutaneous Endoscopy Cervical Discectomy Using 3.7 mm Endoscope and 6.9 mm Endoscope 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):  
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.

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

2021 ◽  
Author(s):  
Tong Yu ◽  
Jiu-Ping Wu ◽  
Jun Zhang ◽  
Hai-Chi Yu ◽  
Qinyi 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.

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.

scholarly journals Comparative Evaluation of Keyhole Technique and Delta Technique 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):  
Soft Tissue ◽  
Clinical Outcomes ◽  
Disc Herniation ◽  
Operation Time ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Tissue Removal ◽  
Significant Difference ◽  
Cord Injury ◽  
Cervical Diseases

Abstract Background 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 keyhole technique (diameter of 3.7 mm) and delta technique (diameter of 6.9 mm) in CDH patients. The purpose of this study was to compare the clinical outcomes of unilateral cervical disc herniation (CDH) patients treated with posterior percutaneous endoscopic cervical discectomy (p-PECD) applying the keyhole technique with those treated with the delta technique.Methods From January 2016 to June 2018, totally 28 consecutive patients presented with single-level CDH who received p-PECD using the keyhole technique or the delta technique were enrolled in this study. 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 In both groups, faster “V” point identification, more quickly overlying soft tissue removal and laminoforaminotomy, and shorter operative time, were found in the delta group. Postoperatively, the VAS and MacNab scores of the two techniques were improved significantly. Nevertheless, the differences between the two groups were not significant (P>0.05). One case suffered nerve root outer membrane torn in delta group.Conclusion Both keyhole technique and delta technique are effective methods for CDH in selected patients, and there is no significant difference in clinical outcomes. Delta technology is superior to keyhole technology in the efficiency of “V” point identification, overlying soft tissue removal and spinal cord injury prevention. Furthermore, delta technology is inferior to keyhole technology in anterior decompression of the intervertebral foramen.

scholarly journals Surgery in cervical disc herniation: anterior cervical discectomy without fusion or with fusion

2017 ◽  
Vol 31 (1) ◽  
pp. 54-58
Author(s):  
Andrei Stefan Iencean
Keyword(s):  
Range Of Motion ◽  
Disc Herniation ◽  
Clinical Results ◽  
Small Degree ◽  
Anterior Cervical Discectomy ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Cervical Discectomy ◽  
Single Level ◽  
Anteroposterior Translation

Abstract The study included a group of anterior cervical microdiscectomy without fusion performed at one level (either C5-C6 level or at the C6-C7 level) and a second group of patients with same single-level of anterior cervical discectomy with fusion. The kinematic analysis included the range of motion, anteroposterior translation and disc height assessed for the cervical functional spinal units at the operated level and adjacent levels. At the operated level the range of motion and the translation were minimal in the anterior cervical discectomy without fusion group, both for the C5-C6 and C6-C7 levels, and absent in the cervical discectomy with fusion group. The superior adjacent levels translations were greater in the ACDF group compared with the ACD group. The clinical results of both types of cervical discectomy were comparable. In cervical microdiscectomy without fusion the elastic fibrous intradiscal scar at the operated level allows a small degree of mobility and the adjacent cervical levels are not overstressed. No need for anterior cervical discectomy with fusion to trait a single level cervical disc herniation than in selected cases.

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