Short-term effect of soft endoscope-assisted single-segment cervical artificial disc replacement in the treatment of cervical spondylosis

English Keywords:Cervical spondylosis  Artificial disc replacement  Soft endoscope  Minimally invasive surgery

English Abstract:

  【Abstract】 Objectives: To investigate the short-term effect of soft endoscope-assisted single-segment cervical artificial disc replacement(ADR) in the treatment of cervical spondylosis. Methods: A retrospective analysis was conducted on the clinical data of 24 cases of cervical spondylosis treated with soft endoscope-assisted single-segment ADR in our hospital from June 2023 to May 2024, of which, 8 cases were male and 16 cases were female, aged 25 to 68 years old(47.0±11.9 years old). There were 7 cases of cervical spondylotic radiculopathy, 14 cases of cervical spondylotic myelopathy, and 3 cases of mixed cervical spondylosis. All of the patients were with single-segment lesions, including 2 cases of C3/4, 6 cases of C4/5, 12 cases of C5/6, and 4 cases of C6/7. The length of surgical incision, intraoperative bleeding, operative time, postoperative drainage, hospitalization time and complications were recorded; Prevertebral soft tissue edema was evaluated; Japanese Orthopaedic Association(JOA) score was assessed for cervical spine motor function, and visual analog scale(VAS) score was evaluated for neck and shoulder pain on 1d before surgery, at 1 week after surgery, 1 month and 3 months after surgery. Results: Surgery was successfully completed in all patients, and no complications such as spinal cord/nerve root injury or cerebrospinal fluid leakage were detected during the operation. Operative time was 34-123min(66.6±20.8min), length of surgical incision was 2.5-3cm(2.6±0.2cm), intraoperative bleeding volume was 5-50mL(19.6±12.6mL), postoperative drainage volume was 0-60mL(13.5±18.8mL), and postoperative hospitalization time was 3-8d(5.1±1.6d). No postoperative complications such as cervical subcutaneous hematoma and dysphagia were observed. Postoperative imaging revealed no significant prevertebral soft tissue edema. The postoperative VAS and J0A scores were significantly improved at all time points compared with the preoperative values(P<0.05). The overall efficacy was assessed according to the improvement rate of JOA score at 3 months after surgery: 12 cases were excellent, 12 cases were good, and the rate of excellent and good was 100%(24/24). Conclusions: Soft endoscope-assisted single-segment ADR for the treatment of cervical spondylosis is small in trauma and short in operative time, which has certain clinical application prospects.