Posterior microendoscopic discectomy for single-level cervical spondylotic radiculopathy

English Keywords:Cervical spondylotic radiculopathy  Microendoscopic discectomy  Single-level

English Abstract:

  【Abstract】 Objectives: To investigate the clinical results of posterior microendoscopic discectomy for single-level cervical spondylotic radiculopathy. Methods: A retrospective review was performed on 16 patients with cervical spondylotic radiculopathy undergoing microendoscopic discectomy from September 2010 to August 2012. There were 11 males and 5 females with an average age of 41.7 years(range, 31-56 years). The level of herniation was C4/5 in 4 cases, C5/6 in 9 cases and C6/7 in 3 cases. All patients had clinical presentations and neurological examinations consistent with a single-level unilateral herniated nucleus pulposus, which was refractory to more than 6 weeks of conservative management. These diagnoses were determined by computed tomography scans and magnetic resonance imaging. Dynamic instability was verified under extension and flexion X-ray. Clinical efficacy was evaluated by VAS score, JOA score, cervical curvature, the stability and disc height at surgical segment. Results: The average operation time was 89min(range, 75-115min); the average blood loss during operation was 85ml(range, 30-160ml); the average length of hospital stay was 4.1 days(3-7 days). Radicular symptoms relieved in 11 cases and improved significantly in 5 cases when discharged. All cases were followed up for 6-25 months(average, 12.7 months). VAS decreased from 7.13±1.15 preoperatively to 3.00±0.63 postoperatively, and 1.94±0.85 at final follow-up, and JOA score increased from 12.63±1.09 preoperatively to 15.63±0.50 postoperatively, and 16.13±0.62 at final follow-up, which showed significant difference among the data of preoperation, postoperation and final follow-up(P<0.05). Cervical curvature increased from 7.66±0.99mm to 10.99±0.95mm at final follow-up, which showed significant difference(P<0.05). Disc height in surgical level of preoperation and at final follow-up was 5.56±0.54mm and 5.54±0.52mm respectively, which showed no significant difference(P＞0.05). No radiographic instability was revealed on dynamic radiographs after operation. Conclusions: Based on strict indication, satisfactory clinical results can be achieved by posterior microendoscopic discectomy with minimal invasion for single-level cervical spondylotic radiculopathy.