scholarly journals Percutaneous plasma laser disc coagulation and navigable ablation decompression in the treatment of cervical disc herniation: A single center experience.

2019 ◽  
Author(s):  
AYŞEGÜL CEYLAN ◽  
İBRAHİM AŞIK
Keyword(s):  
Disc Herniation ◽  
Cervical Vertebrae ◽  
Treatment Success ◽  
Clinical Signs ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Satisfaction Scale ◽  
Single Center Experience ◽  
Percutaneous Procedures ◽  
Proper Patient Selection

Backgraund and aim: We aimed to compare the effectivity of PDCT (Percutaneous Disc Coagulation Therapy) and L-DISQ (navigable ablation decompression treatment) in patients who were diagnosed with cervical disc herniation. Methods: Visual Analogue Scale (VAS), Neck Pain Index (NPI) were recorded initially and at the 1st, 3rd, 6th and 12th months after the procedures. Patient Satisfaction Scale (PSS) were recorded 12th months after the procedures. Results: Mean VAS scores were 7.55 and 3.1 points in PDCT group and 7.6 and 3.00 points in L-DISQ group mean NPI scores were 34.2 and 20.75 points in PDCT group and 34.1 and 20.4 points in L-DISQ group initially and at the 12th month. When compared between months, there was a significant decrease in time-dependent VAS and NPI scores in both PDCT and L-DISQ groups (p=0.001). Some complications include esophageal, vascular and neural injuries, hoarseness, Horner syndrome, infections, dural puncture and muscle spasm. The only difference between groups was the rate of cervical spasm within one month after the procedure; 75% in PDCT group and 15% in L-DISQ group. Conclusion: The diameter of the canal of cervical vertebrae is narrower than of the lumbar and thoracic regions, therefore the smaller part of disc may be sufficient to create clinical signs. The respond to decompression therapies are faster in case cervical percutaneous procedures are performed correctly. Proper patient selection and practitioner’s experience are important in treatment success. Key Words: Navigable ablation, intradiscal decompression, PDCT, cervical herniation

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 Self Manipulated Cervical Spine Leads to Posterior Disc Herniation and Spinal Stenosis

2019 ◽  
Vol 9 (6) ◽  
pp. 125 ◽  
Author(s):  
Wyatt McGilvery ◽  
Marc Eastin ◽  
Anish Sen ◽  
Maciej Witkos
Keyword(s):  
Emergency Department ◽  
Neck Pain ◽  
Spinal Stenosis ◽  
Disc Herniation ◽  
Spinal Manipulation ◽  
Cervical Spinal Cord ◽  
Cervical Vertebrae ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Manipulation Therapy

The authors report a case in which a 38-year-old male who presented himself to the emergency department with a chief complaint of cervical neck pain and paresthesia radiating from the right pectoral region down his distal right arm following self-manipulation of the patient’s own cervical vertebrae. Initial emergency department imaging via cervical x-ray and magnetic resonance imaging (MRI) without contrast revealed no cervical fractures; however, there was evidence of an acute cervical disc herniation (C3–C7) with severe herniation and spinal stenosis located at C5–C6. Immediate discectomy at C5–C6 and anterior arthrodesis was conducted in order to decompress the cervical spinal cord. Acute traumatic cervical disc herniation is rare in comparison to disc herniation due to the chronic degradation of the posterior annulus fibrosus and nucleus pulposus. Traumatic cervical hernias usually arise due to a very large external force causing hyperflexion or hyperextension of the cervical vertebrae. However, there have been reports of cervical injury arising from cervical spinal manipulation therapy (SMT) where a licensed professional applies a rotary force component. This can be concerning, considering that 12 million Americans receive SMT annually (Powell, F.C.; Hanigan, W.C.; Olivero, W.C. A risk/benefit analysis of spinal manipulation therapy for relief of lumbar or cervical pain. Neurosurgery 1993, 33, 73–79.). This case study involved an individual who was able to apply enough rotary force to his own cervical vertebrae, causing severe neurological damage requiring surgical intervention. Individuals with neck pain should be advised of the complications of SMT, and provided with alternative treatment methods, especially if one is willing to self manipulate.

scholarly journals An Outcome Study of Anterior Cervical Discectomy and Fusion among Iranian Population

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Ali Haghnegahdar ◽  
Mahsa Sedighi
Keyword(s):  
Disc Herniation ◽  
Treatment Success ◽  
Japanese Orthopaedic Association ◽  
Radicular Pain ◽  
Iranian Population ◽  
Cervical Disc Herniation ◽  
Cervical Disc ◽  
Functional Score ◽  
Functional Scores

Background and Aim. First-line treatment strategy for managing cervical disc herniation is conservative measures. In some cases, surgery is indicated either due to signs/symptoms of severe/progressive neurological deficits, or because of persistence of radicular pain despite 12 weeks of conservative treatment. Success for treatment of cervical disc herniation using ACDF has been successfully reported in the literature. We aim to determine the outcome of ACDF in treatment of cervical disc herniation among Iranians. Methods and Materials/Patients. In a retrospective cohort study, we evaluated 68 patients who had undergone ACDF for cervical disc herniation from March 2006 to March 2011. Outcome tools were as follows: (1) study-designed questionnaire that addressed residual and/or new complaints and subjective satisfaction with the operation; (2) recent (one week prior to the interview) postoperative VAS for neck and upper extremity radicular pain; (3) Japanese Orthopaedic Association Myelopathy Evaluation Questionnaire (JOACMEQ) (standard Persian version); and (4) follow-up cervical Magnetic Resonance Imaging (MRI) and lateral X-ray. Results. With mean follow-up time of 52.93 (months) ± 31.89 SD (range: 13–131 months), we had success rates with regard to ΔVAS for neck and radicular pain of 88.2% and 89.7%, respectively. Except QOL functional score of JOAMEQ, 100% success rate for the other 4 functional scores of JOAMEQ was achieved. Conclusion. ACDF is a successful surgical technique for the management of cervical disc herniation among Iranian population.

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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