Top

BMC Musculoskeletal Disorders

Published in:

Open Access 01-12-2019 | Endoscopy | Research article

Clinical application of large channel endoscopic decompression in posterior cervical spine disorders

Authors: Chengli Li, Xiaojie Tang, Song Chen, Yongchun Meng, Wei Zhang

Published in: BMC Musculoskeletal Disorders | Issue 1/2019

Abstract

Background

We investigated the clinical value of posterior percutaneous endoscopic decompression (PED) for single-segment cervical spondylotic myelopathy (CSM) and cervical spondylotic radiculopathy (CSR). Methods: Clinical data from February 2016 to March 2018 were collected for 32 patients with single-segment CSM or CSR who underwent posterior cervical percutaneous large channel endoscopic decompression and completed a regular follow-up exam at 12 months after surgery. Patient data included: age (range 30–81 years and mean of 49.5 years) and surgical information (operation time, bleeding volume, hospital stay, complications, etc.). The Japan Orthopedic Association (JOA) score and pain visual analog scale (VAS) were used to evaluate the surgical outcome for each patient. Cervical spine radiographs were used to evaluate cervical curvature (Cervical spondylotic angle (CSA), C2–7 Cobb angle) and CT and MRI were used to assess the extent of laminectomy and nerve root decompression. The JOA score, VAS score, cervical curvature were analyzed statistically, and the clinical outcome was evaluated using modified Macnab criteria at the last patient follow-up exam.

Results

The JOA and VAS scores were compared before and after surgery (1 day Pre-op; 3 days, 3 months and 12 months Post-op). The differences were statistically significant (P < 0.05). There were significant differences in cervical curvature (C2–7 Cobb angle) between the time points (1 day Pre-op; 3 days, 3 months and 12 months Post-op), but the differences were no statistically significant in CSA angle (P < 0.05) The operation time range was 45–110 min (mean 68.6 ± 23.8 min); the intraoperative blood loss range was 20–85 ml (mean28 ± 14.8 ml), and the hospital stay was 3–8 days (mean4.5 days). At the last follow-up, the clinical efficacy was evaluated using modified Macnab criteria. The results were excellent in 18 cases, good in 11 cases, and fair in 3 cases. The combined excellent and good rate was 93.75%. Postoperative CT and MRI showed that the compression of the spinal cord or nerve roots was completely relieved.

Conclusion

Endoscopic decompression of posterior cervical vertebral disorders is a safe, effective, and minimally invasive surgical procedure with rapid recovery times. This procedure warrants additional research and clinical application.

Ke Z, Wang J. Progress in epidemiology and pathogenesis of cervical spondylosis. J Cervicodynia Lunbodynia. 2014;1:62–4. https://doi.org/10.3969/j.issn.1005-7234.2014.01.017.CrossRef

Epstein NE. Laminectomy for cervical myelopathy. Spinal Cord. 2003;41(6):317–27. https://doi.org/10.1038/sj.sc.3101477.CrossRefPubMed

Moon MS. Neck and shoulder pain after laminoplasty. Spine. 1997;22(14):1674–6.CrossRef

Satomi K, Nishu Y, Kohno T, et al. Long-term follow-up studies of open-door expansive laminoplasty for cervical stenotic myelopathy. Spine. 1994;19(5):507–10.CrossRef

Hiroshi M, Koichiro M, Koki U, et al. Outcomes of surgical intervention for cervical spondylotic myelopathy accompanying local kyphosis (comparison between laminoplasty alone and posterior reconstruction surgery using the screw-rod system). Eur Spine J. 2014;23(2):341–6. https://doi.org/10.1007/s00586-013-2923-1.CrossRef

Zhang J, Sun D, Huang X. Progress and clinical significance of cervical curvature measurement. Chin J Rehabil. 2009;24(5):347–9. https://doi.org/10.3870/zgkf.2009.05.030.CrossRef

Ruetten S, Komp M, Godolias G. A new full-endoscopic technique for the interlaminar operation of lumbar disc herniations using 6-mm endoscopes: prospective 2-year results of 331 patients. Minim Invasive Neurosurg. 2006;49(02):80–7. https://doi.org/10.1055/s-2006-932172.CrossRefPubMed

Fujibayashi S, Neo M, Yoshida M, et al. Neck muscle strength before and after cervical laminoplasty: relation to axial symptoms. J Spinal Disord Tech. 2010;23(3):197–202. https://doi.org/10.1097/BSD.0b013e3181a1a73e.CrossRefPubMed

Chul Bum C, Chung Kee C, Jong Yang O, et al. Axial neck pain after cervical laminoplasty. J Korean Neurosurg Soc. 2010;47(2):107–11. https://doi.org/10.3340/jkns.2010.47.2.107.CrossRef

10.

Kowatari K, Ueyama K, Sannohe A, et al. Preserving the C7 spinous process with its muscles attached: effect on axial symptoms after cervical laminoplasty. J Orthop Sci. 2009;14(3):279–84. https://doi.org/10.1007/s00776-009-1331-1.CrossRefPubMed

11.

Yeung AT. Minimally invasive disc surgery with the Yeung endoscopic spine system (YESS)[J]. Surg Technol Int. 1999;8:267–77.PubMed

12.

Chiu JC. Evolving transforaminal endoscopic microdecompression for herniated lumbar discs and spinal stenosis. Surg Technol Int. 2004;13:276–86.PubMed

13.

Quillo-Olvera J, Lin G, Kim J. Percutaneous endoscopic cervical discectomy: a technical review. Ann Transl Med. 2018;6(6):100. https://doi.org/10.21037/atm.2018.02.09.CrossRefPubMedPubMedCentral

14.

Tzaan WC. Anterior percutaneous endoscopic cervical discectomy for cervical intervertebral disc herniation: outcome, complications, and technique. J Spinal Disord Tech. 2011;24(7):421–31. https://doi.org/10.1097/BSD.0b013e31820ef328.CrossRefPubMed

15.

Yang J, Chu L, Chen L, et al. Anterior or posterior approach of full-endoscopic cervical discectomy for cervical intervertebral disc herniation? A comparative cohort study. Spine. 2014;39(21):1743–50. https://doi.org/10.1097/brs.0000000000000508.CrossRefPubMed

16.

Nakamura S, Taguchi M. Percutaneous endoscopic cervical discectomy: surgical approaches and postoperative imaging changes. Asian Spine J. 2018;12(2):294–9. https://doi.org/10.4184/asj.2018.12.2.294.CrossRefPubMedPubMedCentral

17.

Kim CH, Park TH, Chung CK, et al. Changes in cervical motion after cervical spinal motion preservation surgery. Acta Neurochir. 2018;160(2):397–404. https://doi.org/10.1007/s00701-017-3375-x.CrossRefPubMed

18.

Kim CH, Shin K-H, Chung CK, et al. Changes in cervical sagittal alignment after single-level posterior percutaneous endoscopic cervical diskectomy. Global Spine J. 2015;5(1):31–8. https://doi.org/10.1055/s-0034-1395423.CrossRefPubMed

19.

Liu C, Liu K, Chu L, et al. Posterior percutaneous endoscopic cervical discectomy through Lamina-hole approach for cervical intervertebral disc herniation. Int J Neurosci. 2018:1–13. https://doi.org/10.1080/00207454.2018.1503176.CrossRef

20.

Wang P, Liao W. Surgical design and clinical application of posterior percutaneous full-endoscopic cervical foraminotomy for cervical osseous foraminal stenosis. Chin J Reparative Reconstr Surg. 2018;32(5):536–41. https://doi.org/10.7507/1002-1892.201801029.CrossRef

21.

Pan L, Li Z, Ma L, et al. Applied anatomy of intraspinal venous plexus. Chin J Clin Neurosurg. 2006;11(11):664–6. https://doi.org/10.3969/j.issn.1009-153X.2006.11.009.CrossRef

22.

Ma J, Ye XJ, Xi YH, et al. Clinical efficacy of posterior percutaneous endoscopic discectomy for cervical spondylotic radiculopathy. Chin J Orthop. 2018;38(16):971–80. https://doi.org/10.3760/cma.j.issn.0253-2352.2018.16.002.CrossRef

23.

Shu N, Taguchi M. Area of Ostectomy in posterior percutaneous endoscopic cervical Foraminotomy: images and mid-term outcomes. Asian Spine J. 2017;11(6):968–74. https://doi.org/10.4184/asj.2017.11.6.968.CrossRef

24.

Ruetten S, Komp M, Merk H, et al. A new full-endoscopic technique for cervical posterior Foraminotomy in the treatment of lateral disc Herniations using 6.9-mm endoscopes: prospective 2-year results of 87 patients. Minim Invasive Neurosurg. 2007;50(04):219–26. https://doi.org/10.1055/s-2007-985860.CrossRefPubMed

25.

Ruetten S, Komp M, Merk H, et al. Full-endoscopic cervical posterior foraminotomy for the operation of lateral disc herniations using 5.9-mm endoscopes: a prospective, randomized, controlled study. Spine. 2008;33(9):940–8. https://doi.org/10.1097/brs.0b013e31816c8b67.CrossRefPubMed

26.

Kim CH, Kim K-T, Chung CK, et al. Minimally invasive cervical foraminotomy and diskectomy for laterally located soft disk herniation. Eur Spine J. 2015;24(12):3005–12. https://doi.org/10.1007/s00586-015-4198-1.CrossRefPubMed

27.

Du Q, Wang X, Qin J, et al. Percutaneous Full-Endoscopic Anterior Transcorporeal Procedure for Cervical Disc Herniation: A Novel Procedure and Early Follow-Up Study. World Neurosurg. 2018;112:e23–30. https://doi.org/10.1016/j.wneu.2017.12.001.CrossRefPubMed

Title: Clinical application of large channel endoscopic decompression in posterior cervical spine disorders
Authors: Chengli Li
Xiaojie Tang
Song Chen
Yongchun Meng
Wei Zhang
Publication date: 01-12-2019
Publisher: BioMed Central
Keyword: Endoscopy
Published in: BMC Musculoskeletal Disorders / Issue 1/2019
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-019-2920-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Clinical application of large channel endoscopic decompression in posterior cervical spine disorders

Abstract

Background

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2019

Topical tranexamic acid in elderly patients with femoral neck fractures treated with hemiarthroplasty: efficacy and safety? - a case-control study

Obstacles to returning to work with chronic pain: in-depth interviews with people who are off work due to chronic pain and employers

No added value for Computer-Assisted surgery to improve femoral component positioning and Patient Reported Outcomes in Hip Resurfacing Arthroplasty; a multi-center randomized controlled trial

GLA:D® Back: implementation of group-based patient education integrated with exercises to support self-management of back pain - protocol for a hybrid effectiveness-implementation study

Footwear fit in schoolchildren of southern Spain: a population study

Novel implant-free loop Tenodesis vs. simple Tenotomy of the long biceps tendon - a biomechanical investigation