Anterior Minimally Invasive Approaches for the Cervical Spine

Lee, Sang-Ho; Lee, June Ho; Choi, Won-Chul; Jung, Byungjoo; Mehta, Rajendra

doi:10.1016/j.ocl.2007.02.007

Cited by 43 publications

(35 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are two variants of cervical discectomy that are in clinical use; namely, the standard or open method and the minimally-invasive or percutaneous method [1,[3][4][5][6][7][8][9]. There are no biomechanical comparisons of these two variants.…”

Section: Discussionmentioning

confidence: 99%

“…Although both conventional and minimally-invasive techniques for cervical discectomy have been shown to be safe, efficacious, and with low rates of postoperative surgical site infections [1,3,[5][6][7][8]34], to the best of our knowledge, there are no literature reports (case studies, prospective data from surgical registries, or prospective, randomized, controlled trials) on comparison of these two variants on the basis of, for example, duration of surgery and clinical outcomes. This situation contrasts with that for lumbar discectomy, in which there are comparisons of conventional and minimally-invasive techniques on the basis of, for example, length of operating time, blood loss, duration of hospital stay, surgical complications, and outcome measures (such as changes in Visual Analogue Scale, Oswestry Disability Index, and the Core Outcome Measures Index after the surgery) and duration of hospital stay [35][36][37]), These comparisons found no significant difference in, for example, rate of surgical complications, duration of hospital stay, and any outcome measures between the two variants [35][36][37].…”

Section: Discussionmentioning

confidence: 99%

“…These are anterior cervical discectomy followed by fusion (ACDF) (the most popular method) [1,2]; discectomy without fusion (DISWF) (used in a modest number of cases) [1,[3][4][5][6][7][8][9]; percutaneous nucleotomy (used in a few cases) [10]; total disc replacement (recently approved by regulatory bodies, such as the US Food and Drug Administration) [11][12][13]; and nucleus pulposus (NP) replacement [14] and intervertebral disc transplant [15] (each being an emerging option).…”

Section: Introductionmentioning

confidence: 99%

“…One is referred to as the conventional, standard, or open approach [1,3,4] while the other is a family of minimally-invasive procedures, namely, percutaneous cervical discectomy, percutaneous endoscopic cervical discectomy, percutaneous cervical laser decompression, percutaneous microcompressive endoscopic cervical discectomy microdiscectomy [5][6][7][8][9]. Arguably, the two most important driving forces for the introduction and increasing popularity of the latter techniques are to utilize a narrower surgical entry window and to reduce the amount of soft tissue that is disrupted and/or excisedin addition to the affected parts of the disccompared to the former procedure [16].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Conventional versus minimally-invasive cervical discectomy for treatment of severe degenerative disease at C5-C6: a biomechanical comparison using a model of the full cervical spine and finite element analysis

Li¹,

Lewis²

2011

JBiSE

View full text Add to dashboard Cite

The purpose of this study was to determine the differences in biomechanical responses of tissues in the cervical spine when pain and other problems secondary to severe disc degeneration disease are surgically treated by conventional discectomy (CONDIS) compared to minimally-invasive discectomy (MIVDIS). A validated three-dimensional model of an intact, healthy, adult full cervical spine (C1-C7) (INT) was constructed. This model was then modified to create two models, one simulating each of the above-mentioned two techniques for discectomy of the severely degenerated C5-C6 disc. For each of these three models, we used the finite element analysis method to obtain four biomechanical parameters at various tissues in the model, under seven different physiologically relevant loadings. For each of the biomechanical parameters, the results were expressed as relative change in its value when a specified combination of simulated discectomy model and applied loading was used, with respect to the corresponding value in the intact model. We then computed the value of a composite biomechanical performance index (CBPI) for CONDIS and MIVDIS models, with this value incorporating all of the aforementioned relative changes. We found that CBPI was marginally lower for MIVDIS model. This trend is the same as that reported for the relative complications rate and outcome measures following conventional and minimally-invasive discectomies in the lumbar spine. From a healthcare perspective, one implication of our finding is that minimally-invasive cervical discectomy should be considered an attractive option provided that detailed patient selection criteria are clearly defined and strictly followed.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Conventional versus minimally-invasive cervical discectomy for treatment of severe degenerative disease at C5-C6: a biomechanical comparison using a model of the full cervical spine and finite element analysis

Li¹,

Lewis²

2011

JBiSE

View full text Add to dashboard Cite

show abstract

“…The most common surgical procedure for discogenic cervical pain is open discectomy by the anterior approach; however, this type of technique is associated with complication rates of around 4%, and mortality rates of between 0.14% and 0.42%. 3,4 By contrast, minimally invasive percutaneous techniques provide benefits such as smaller incisions, shorter hospitalization times, less postoperative pain, and faster recovery, 5 with complication rates of below 1%. 6,7 One minimally invasive treatment for axial cervical pain is percutaneous non-endoscopic cervical discectomy and nucleoplasty.…”

Section: Introductionmentioning

confidence: 99%

Anterior Percutaneous Cervical Discectomy. Two-Year Follow-Up of a Blunt Technique Procedure

León¹,

Ortíz²,

Martínez³

et al. 2017

Coluna/Columna

View full text Add to dashboard Cite

Objective: To report the outcomes of non-endoscopic percutaneous cervical discectomy by anterior blunt approach for the treatment of degenerative disc disease. Methods: A review of the medical records of patients with axial cervical pain resulting from degenerative disc disease and treated with discectomy and percutaneous nucleoplasty by anterior blunt approach with radiofrequency source was carried out. The data were evaluated according to modified MacNab and pre-and postoperative VAS criteria at 3, 12 and 24 months. Results: Sixty-two procedures were performed in 48 patients between 2008 and 2014. The mean age of the population was 52.4 years. MacNab results were 84.6%, 92.3%, and 89.2% improvement (excellent and good results) at 3, 12 and 24 months, respectively. The VAS changed from 7.4 to 2.3 two years after the procedure, showing a statistically significant difference (p=0.000). There were no major complications or re-interventions related to the technique. Conclusions: Anterior non-endoscopic discectomy and nucleoplasty for the treatment of discogenic axial cervical pain may be an effective alternative to open surgery. In the two-year follow-up, our blunt technique proved to be a safe procedure with no approach-related complications, and provided outcomes comparable to those reported using the original needle technique.Keywords: Spine; Intervertebral disc degeneration; Neck pain; Diskectomy, percutaneous; Minimally invasive surgical procedures. RESUMO

show abstract

Patient selection criteria for percutaneous anterior cervical laser versus endoscopic discectomy

Hellinger¹,

Knight

Telfeian

et al. 2022

Lasers Surg Med

View full text Add to dashboard Cite

Background: Percutaneous anterior laser and anterior endoscopic cervical spine surgery are associated with less approach trauma than conventional open cervical spine surgery. The literature illustrating their appropriate use corroborated with objective outcome evidence is scarce. The authors were interested in comparing the clinical outcomes following percutaneous laser disc decompression (PLDD) versus percutaneous endoscopic disc decompression (PEDD). © 2021 Wiley Periodicals LLC. Materials and Methods: Thirty patients with soft contained symptomatic cervical disc herniations and an average age of 50.5 years (range 26 -68 years; 16 males and 14 females) were prospectively enrolled in 2 groups of 15 patients to be either treated with PLDD or PEDD. All patients underwent PLDD or PEDD under local anesthesia and sedation. Clinical outcomes were assessed with the Macnab criteria VAS score for arm pain. Complications and reoperations were recorded. Results: There were significant reductions in the VAS score for arm pain from preoperative 8.4 ± 2.5 to 3.1 ± 1.2 in the PLDD group (P < 0.03), and from preoperative 8.6 ± 2.7 to 2.4 ± 1.1 (P < 0.01) in the PEDD group. In the PLDD group, Macnab outcomes were excellent in 21% of patients, good in 44%, fair in 21%, and poor in 14%. In the PEDD group, Macnab outcomes were excellent in 14% of patients, good in 32%, fair in 12%, and poor in the remaining 12%. There were no statistically significant differences in clinical outcomes between the PLDD and the PEDD group. There were no approach-related or surgical complications. Conclusions: Tissue trauma is significantly reduced with laser and endoscopic surgery techniques. PLDD and PEDD are both suitable for the specific indication of soft, symptomatic contained cervical disc herniations. The authors' small prospective cohort study indicates that PLDD and PEDD are options for cervical decompression surgery when medical comorbidities or preferences by patients and surgeons dictate more minimally invasive strategies.

show abstract

Anterior Minimally Invasive Approaches for the Cervical Spine

Cited by 43 publications

References 15 publications

Conventional versus minimally-invasive cervical discectomy for treatment of severe degenerative disease at C5-C6: a biomechanical comparison using a model of the full cervical spine and finite element analysis

Conventional versus minimally-invasive cervical discectomy for treatment of severe degenerative disease at C5-C6: a biomechanical comparison using a model of the full cervical spine and finite element analysis

Anterior Percutaneous Cervical Discectomy. Two-Year Follow-Up of a Blunt Technique Procedure

Patient selection criteria for percutaneous anterior cervical laser versus endoscopic discectomy

Contact Info

Product

Resources

About