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J Neurol Surg A Cent Eur Neurosurg 2021; 82(03): 197-203
DOI: 10.1055/s-0040-1709166
Original Article

Posterior Endoscope-Assisted Diskectomy Is an Effective Technique for Cervical Soft Disk Herniation

Derya Gündoğdu Karaoglu
1   Ankara Numune Research and Training Hospital, Neurosurgery Clinic, Ankara, Turkey
,
Omer Polat
2   Düzce University, School of Medicine, Department of Neurosurgery, Düzce, Turkey
,
Ozhan Merzuk Uckun
1   Ankara Numune Research and Training Hospital, Neurosurgery Clinic, Ankara, Turkey
,
Resul Karadeniz
1   Ankara Numune Research and Training Hospital, Neurosurgery Clinic, Ankara, Turkey
,
Deniz Belen
1   Ankara Numune Research and Training Hospital, Neurosurgery Clinic, Ankara, Turkey
,
Ali Dalgic
1   Ankara Numune Research and Training Hospital, Neurosurgery Clinic, Ankara, Turkey
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Abstract

Objective To evaluate the clinicoradiologic conditions of patients with a herniated cervical disk who were treated with percutaneous endoscope-assisted cervical diskectomy.

Materials and Methods The medical data of 27 patients (16 men and 11 women; mean age: 40.9 years) who were operated on with the posterior endoscope-assisted cervical diskectomy method were reviewed retrospectively. The mean follow-up was 35.1 months, and the patients were assessed with combined preoperative and postoperative visual analog scale (VAS), Prolo Functional Economic Outcome Rating scale, MacNab scale, and clinical imaging.

Results The mean preoperative VAS level was 8.6 (range: 7–10), and mean Prolo score was 2.5 (range: 2–5). A postoperative assessment performed 1 week postsurgery found a mean VAS level of 2.1 (range: 0–4). At the final examination, the mean VAS level was 0.81 (range: 0–3), and the mean Prolo score was 4.5 (range: 3–5). The final MacNab scale scores were 62.9%, excellent; 25.9%, good; 7.4%, moderate; and 3.7%, poor.

Conclusion Percutaneous endoscope-assisted cervical diskectomy is a suitable and effective treatment method for soft cervical disk herniation.

Keywords

spine - cervical disk herniation - diskectomy - endoscopy - endoscope assisted


Publication History

Received: 08 February 2019

Accepted: 30 July 2019

Article published online:
06 January 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Cloward RB. The anterior approach for removal of ruptured cervical disks. J Neurosurg 1958; 15 (06) 602-617
    CrossrefPubMedGoogle Scholar
  • 2 Fountas KN, Kapsalaki EZ, Nikolakakos LG. et al. Anterior cervical discectomy and fusion associated complications. Spine 2007; 32 (21) 2310-2317
    CrossrefPubMedGoogle Scholar
  • 3 Wilson JR, Radcliff K, Schroeder G. et al. Frequency and acceptability of adverse events after anterior cervical discectomy and fusion: a survey study from the Cervical Spine Research Society. Clin Spine Surg 2018; 31 (05) E270-E277
    CrossrefPubMedGoogle Scholar
  • 4 Pirkle S, Kaskovich S, Cook DJ, Ho A, Shi LL, Lee MJ. Cages in ACDF are associated with a higher nonunion rate than allograft: a stratified comparative analysis of 6130 patients. Spine 2019; 44 (06) 384-388
    CrossrefPubMedGoogle Scholar
  • 5 Noordhoek I, Koning MT, Jacobs WCH, Vleggeert-Lankamp CLA. Incidence and clinical relevance of cage subsidence in anterior cervical discectomy and fusion: a systematic review. Acta Neurochir (Wien) 2018; 160 (04) 873-880
    CrossrefPubMedGoogle Scholar
  • 6 Carrier CS, Bono CM, Lebl DR. Evidence-based analysis of adjacent segment degeneration and disease after ACDF: a systematic review. Spine J 2013; 13 (10) 1370-1378
    CrossrefPubMedGoogle Scholar
  • 7 Wang F, Hou HT, Wang P, Zhang JT, Shen Y. Symptomatic adjacent segment disease after single-lever anterior cervical discectomy and fusion: incidence and risk factors. Medicine (Baltimore) 2017; 96 (47) e8663
    CrossrefPubMedGoogle Scholar
  • 8 Acikbas SC, Ermol C, Akyuz M, Tuncer R. Assessment of adjacent segment degeneration in and between patients treated with anterior or posterior cervical simple discectomy. Turk Neurosurg 2010; 20 (03) 334-340
    PubMedGoogle Scholar
  • 9 Flynn TB. Neurologic complications of anterior cervical interbody fusion. Spine 1982; 7 (06) 536-539
    CrossrefPubMedGoogle Scholar
  • 10 Graffeo CS, Puffer RC, Wijdicks EF, Krauss WE. Delayed cerebral infarct following anterior cervical diskectomy and fusion. Surg Neurol Int 2016; 7: 86
    CrossrefPubMedGoogle Scholar
  • 11 Halani SH, Baum GR, Riley JP. et al. Esophageal perforation after anterior cervical spine surgery: a systematic review of the literature. J Neurosurg Spine 2016; 25 (03) 285-291
    CrossrefPubMedGoogle Scholar
  • 12 Veeravagu A, Cole T, Jiang B, Ratliff JK. Revision rates and complication incidence in single- and multilevel anterior cervical discectomy and fusion procedures: an administrative database study. Spine J 2014; 14 (07) 1125-1131
    CrossrefPubMedGoogle Scholar
  • 13 Goffin J, van Loon J, Van Calenbergh F, Plets C. Long-term results after anterior cervical fusion and osteosynthetic stabilization for fractures and/or dislocations of the cervical spine. J Spinal Disord 1995; 8 (06) 500-508 ; discussion 499
    CrossrefPubMedGoogle Scholar
  • 14 Hilibrand AS, Carlson GD, Palumbo MA, Jones PK, Bohlman HH. Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am 1999; 81 (04) 519-528
    CrossrefPubMedGoogle Scholar
  • 15 Xu S, Liang Y, Zhu Z, Qian Y, Liu H. Adjacent segment degeneration or disease after cervical total disc replacement: a meta-analysis of randomized controlled trials. J Orthop Surg Res 2018; 13 (01) 244
    CrossrefPubMedGoogle Scholar
  • 16 Murrey D, Janssen M, Delamarter R. et al. Results of the prospective, randomized, controlled multicenter Food and Drug Administration investigational device exemption study of the ProDisc-C total disc replacement versus anterior discectomy and fusion for the treatment of 1-level symptomatic cervical disc disease. Spine J 2009; 9 (04) 275-286
    CrossrefPubMedGoogle Scholar
  • 17 Leung C, Casey AT, Goffin J. et al. Clinical significance of heterotopic ossification in cervical disc replacement: a prospective multicenter clinical trial. Neurosurgery 2005; 57 (04) 759-763 ; discussion 759–763
    CrossrefPubMedGoogle Scholar
  • 18 Kim CH, Chung CK, Kim HJ, Jahng TA, Kim DG. Early outcome of posterior cervical endoscopic discectomy: an alternative treatment choice for physically/socially active patients. J Korean Med Sci 2009; 24 (02) 302-306
    CrossrefPubMedGoogle Scholar
  • 19 Casotto A, Buoncristiani P. Posterior approach in cervical spondylotic myeloradiculopathy. Acta Neurochir (Wien) 1981; 57 (3–4): 275-285
    CrossrefPubMedGoogle Scholar
  • 20 Fager CA. Posterolateral approach to ruptured median and paramedian cervical disk. Surg Neurol 1983; 20 (06) 443-452
    CrossrefPubMedGoogle Scholar
  • 21 Epstein JA, Janin Y, Carras R, Lavine LS. A comparative study of the treatment of cervical spondylotic myeloradiculopathy. Experience with 50 cases treated by means of extensive laminectomy, foraminotomy, and excision of osteophytes during the past 10 years. Acta Neurochir (Wien) 1982; 61 (1–3): 89-104
    CrossrefPubMedGoogle Scholar
  • 22 Coric D, Adamson T. Minimally invasive cervical microendoscopic laminoforaminotomy. Neurosurg Focus 2008; 25 (02) E2
    CrossrefPubMedGoogle Scholar
  • 23 Fessler RG, Khoo LT. Minimally invasive cervical microendoscopic foraminotomy: an initial clinical experience. Neurosurgery 2002; 51 (5, Suppl): S37-S45
    CrossrefPubMedGoogle Scholar
  • 24 Kim CH, Kim KT, Chung CK. et al. Minimally invasive cervical foraminotomy and diskectomy for laterally located soft disk herniation. Eur Spine J 2015; 24 (12) 3005-3012
    CrossrefPubMedGoogle Scholar
  • 25 Won S, Kim CH, Chung CK. et al. Comparison of cervical sagittal alignment and kinematics after posterior full-endoscopic cervical foraminotomy and discectomy according to preoperative cervical alignment. Pain Physician 2017; 20 (02) 77-87
    PubMedGoogle Scholar
  • 26 Burkhardt BW, Wilmes M, Sharif S, Oertel JM. The visualization of the surgical field in tubular assisted spine surgery: is there a difference between HD-endoscopy and microscopy?. Clin Neurol Neurosurg 2017; 158: 5-11
    CrossrefPubMedGoogle Scholar
  • 27 Burkhardt BW, Oertel JM. The learning process of endoscopic spinal surgery for degenerative cervical and lumbar disorders using the EasyGO! system. World Neurosurg 2018; 119: 479-487
    CrossrefPubMedGoogle Scholar
  • 28 Kim KT, Kim YB. Comparison between open procedure and tubular retractor assisted procedure for cervical radiculopathy: results of a randomized controlled study. J Korean Med Sci 2009; 24 (04) 649-653
    CrossrefPubMedGoogle Scholar
  • 29 Oertel JM, Philipps M, Burkhardt BW. Endoscopic posterior cervical foraminotomy as a treatment for osseous foraminal stenosis. World Neurosurg 2016; 91: 50-57
    CrossrefPubMedGoogle Scholar
  • 30 Ruetten S, Komp M, Merk H, Godolias G. 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 (09) 940-948
    CrossrefPubMedGoogle Scholar
  • 31 Burkhardt BW, Müller S, Oertel JM. Influence of prior cervical surgery on surgical outcome of endoscopic posterior cervical foraminotomy for osseous foraminal stenosis. World Neurosurg 2016; 95: 14-21
    CrossrefPubMedGoogle Scholar
  • 32 Ruetten S, Komp M, Merk H, Godolias G. 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) 219-226
    Article in Thieme ConnectPubMedGoogle Scholar
  • 33 Oertel JM, Burkhardt BW. Full endoscopic treatment of dural tears in lumbar spine surgery. Eur Spine J 2017; 26 (10) 2496-2503
    CrossrefPubMedGoogle Scholar
  • 34 Müller SJ, Burkhardt BW, Oertel JM. Management of dural tears in endoscopic lumbar spinal surgery: a review of the literature. World Neurosurg 2018; 119: 494-499
    CrossrefPubMedGoogle Scholar
  • 35 Burkhardt BW, Oertel JM. Endoscopic spinal surgery using a new tubular retractor with 15 mm outer diameter. Br J Neurosurg 2019; 18: 1-8
    PubMedGoogle Scholar