Clinical study on the efficacy and safety of percutaneous endoscopic anterior cervical discectomy in the treatment of cervical disc herniation

Ma, Hui; Zhang, Haoping; Zhou, Honggang; Zhao, Xin

doi:10.1007/s00264-021-04982-x

Cited by 8 publications

(9 citation statements)

References 12 publications

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“…PECF is an indirect decompression of the technique through the posterior approach, which requires the removal of the partial bony structure and soft tissue with a radius of 3–4 mm around the V-point (inferior margin of the cephalic lamina, superior margin of the caudal lamina, and the medial border of facet joints [FJ]) to decompress the nerve root ( Kim et al, 2015 ; Ahn, 2016 ; Won et al, 2017 ; Wu P. H. et al, 2021 ). The ATd-ECD technique can achieve precision and direction of approach using contrast agents, but a tunnel needs to be built in the intervertebral disc; after that, the endoscopic instruments remove the protruded disc through the intervertebral space ( Lee and Lee, 2014 ; Quillo-Olvera et al, 2018 ; Haijun et al, 2021 ). Nowadays, PECF and ATd-ECD have gradually become alternative options for spine surgeons in treatment of cervical disc herniation because of their good postoperative stability and high clinical success rate ( Ruetten et al, 2008 ; Yang et al, 2014 ).…”

Section: Introductionmentioning

confidence: 99%

Comparative Analysis of the Biomechanical Characteristics After Different Minimally Invasive Surgeries for Cervical Spondylopathy: A Finite Element Analysis

Zhang

et al. 2021

Front. Bioeng. Biotechnol.

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Minimally invasive surgeries, including posterior endoscopic cervical foraminotomy (PECF), microsurgical anterior cervical foraminotomy (MACF), anterior transdiscal approach of endoscopic cervical discectomy (ATd-ECD), and anterior transcorporeal approach of endoscopic cervical discectomy (ATc-ECD), have obtained positive results for cervical spondylotic radiculopathy. Nonetheless, there is a lack of comparison among them regarding their biomechanical performance. The purpose of this study is to investigate the biomechanical changes of operated and adjacent segments after minimally invasive surgeries compared to a normal cervical spine. A three-dimensional model of normal cervical vertebrae C3–C7 was established using finite element analysis. Afterwards, four surgical models (PECF, MACF, ATd-ECD, and ATc-ECD) were constructed on the basis of the normal model. Identical load conditions were applied to simulate flexion, extension, lateral bending, and axial rotation of the cervical spine. We calculated the range of motion (ROM), intradiscal pressure (IDP), annulus fibrosus pressure (AFP), uncovertebral joints contact pressure (CPRESS), and facet joints CPRESS under different motions. For all circumstances, ATc-ECD was close to the normal cervical spine model, whereas ATd-ECD significantly increased ROM and joints CPRESS and decreased IDP in the operated segment. PECF increased more the operated segment ROM than did the MACF, but the MACF obtained maximum IDP and AFP. Except for ATc-ECD, the other models increased joints CPRESS of the operated segment. For adjacent segments, ROM, IDP, and joints CPRESS showed a downward trend in all models. All models showed good biomechanical stability. With their combination biomechanics, safety, and conditions of application, PECF and ATc-ECD could be appropriate choices for cervical spondylotic radiculopathy.

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Section: Introductionmentioning

confidence: 99%

Comparative Analysis of the Biomechanical Characteristics After Different Minimally Invasive Surgeries for Cervical Spondylopathy: A Finite Element Analysis

Zhang

et al. 2021

Front. Bioeng. Biotechnol.

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“…Since there was significant heterogeneity ( I 2 = 94.3%, P = 0.000) (Additional file 1 : Fig. S4), we conducted a sensitivity analysis and found that the study of Ma et al [ 16 ] had a substantial impact on the results. After removing their study, the heterogeneity test was performed again, and it was found that the heterogeneity was reduced ( I 2 = 84.5%, P = 0.000).…”

Section: Resultsmentioning

confidence: 99%

“…Although pooled results show that the difference in VAS scores at the last follow-up between the PECD group and the ACDF group was not statistically significant, the way PECD relieves pain can delay the degeneration of adjacent segments [ 23 ]. Ma et al [ 16 ] reported that 3 patients (3.3%) in the ACDF group developed adjacent segment disease within two years after surgery, while none developed adjacent segment disease in the PECD group. The pooled results also showed that the neck pain recurrence rate after PECD for cervical disc herniation was only 3%, which further suggests that the long-term efficacy of PECD is stable.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of percutaneous endoscopic cervical discectomy for cervical disc herniation: a systematic review and meta-analysis

et al. 2022

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Background Since there are currently no systematic evidence-based medical data on the efficacy and safety of PECD, this meta-analysis pooled data from studies that reported the efficacy or safety of PECD for cervical disc herniation to examine the efficacy, recurrence and safety of using PECD to treat cervical disc herniation. Methods We searched the PubMed, EMBASE and Cochrane Library databases for studies published from inception to July 2022. Nine nonrandomized controlled trials (non-RCTs) that reported the efficacy or safety of percutaneous endoscopic cervical discectomy for cervical disc herniation were included. We excluded duplicate publications, studies without full text, studies with incomplete information, studies that did not enable us to conduct data extraction, animal experiments and reviews. STATA 15.1 software was used to analyse the data. Results The proportions of excellent and good treatment results after PECD for CDH were 39% (95% CI: 31–48%) and 47% (95% CI: 34–59%), respectively. The pooled results showed that the VAS scores at 1 week post-operatively (SMD = −2.55, 95% CI: − 3.25 to − 1.85) and at the last follow-up (SMD = − 4.30, 95% CI: − 5.61 to − 3.00) after PECD for cervical disc herniation were significantly lower than the pre-operative scores. The recurrence rate of neck pain and the incidence of adverse events after PECD for cervical disc herniation were 3% (95% CI: 1–6%) and 5% (95% CI: 2–9%), respectively. Additionally, pooled results show that the operative time (SMD = − 3.22, 95% CI: − 5.21 to − 1.43) and hospital stay (SMD = − 1.75, 95% CI: − 2.67to − 0.84) were all significantly lower for PECD than for ACDF. The pooled results also showed that the proportion of excellent treatment results was significantly higher for PECD than for ACDF (OR = 2.29, 95% CI: 1.06–4.96). Conclusion PECD has a high success rate in the treatment of CHD and can relieve neck pain, and the recurrence rate and the incidence of adverse events are low. In addition, compared with ACDF, PECD has a higher rate of excellent outcomes and a lower operative time and hospital stay. PECD may be a better option for treating CHD.

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“…[46][47][48] Compared with anterior cervical discectomy and fusion or posterior microdiscectomy, the most significant benefits of PECD are clearer surgical field, less tissue damage, and quicker recovery. 49,50 As shown in the keyword burst detection results, lateral recess stenosis, spinal stenosis, and reoperation are the latest burst terms in recent years, which indicate that these research topics might be considered as the next hotspot in ED research. Additionally, it identifies promising directions for research, which is of interest to scholars and funding agencies.…”

Section: Discussionmentioning

confidence: 97%

“…With the aid of laser and high-speed drills, PECD can complete the resection of central, paracentral, or foraminal soft disc herniations [ 46 - 48 ]. Compared with anterior cervical discectomy and fusion or posterior microdiscectomy, the most significant benefits of PECD are clearer surgical field, less tissue damage, and quicker recovery [ 49 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

Global Trends and Hotspots in Endoscopic Discectomy: A Study Based on Bibliometric Analysis

Yang

et al. 2022

Neurospine

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Objective: With the advancement of minimally invasive spine surgery, endoscopic discectomy (ED) has become a common technique for degenerative disease of the spine. The present study aimed to explore the knowledge structure, emerging trends, and future research hotspots in this field.Methods: All relevant publications on ED from 2002 to 2021 were extracted from the Web of Science databases. Key bibliometric indicators, including countries/regions, institutions, authors, journals, references, and keywords were calculated and evaluated using VOSviewer and CiteSpace software.Results: A total of 1,196 articles and reviews were included for analysis. The number of publications regarding ED increased yearly. From the quality and quantity viewpoint, China, South Korea, and the United States were the major contributors in this field. The most influential institution in the field of ED was Wooridul Spine Hospital. We identified 3,488 authors, among which Lee SH had the most significant number of papers, and Ruetten S was cocited most often. <<i>World Neurosurgery</i> was the journal with the most papers, and <i>Spine</i> was the most commonly cocited journal. Keywords were stratified into 4 clusters by VOSviewer software: cluster 1 (clinical outcomes of ED in the treatment of lumbar disc herniation); cluster 2 (surgical technique of percutaneous endoscopic lumbar discectomy); cluster 3 (clinical outcomes of ED in the treatment of lumbar spinal stenosis); and cluster 4 (clinical outcomes of percutaneous endoscopic cervical discectomy). Several topics including lateral recess stenosis, spinal stenosis, and reoperation were considered as the next hotspot in ED research.Conclusion: ED research has gained considerable attention over the last 2 decades. Our bibliometric findings illuminate the publication trends and research hotspots of the ED field, which may provide useful references for scholars and decision-makers interested in this field.

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Clinical study on the efficacy and safety of percutaneous endoscopic anterior cervical discectomy in the treatment of cervical disc herniation

Cited by 8 publications

References 12 publications

Comparative Analysis of the Biomechanical Characteristics After Different Minimally Invasive Surgeries for Cervical Spondylopathy: A Finite Element Analysis

Comparative Analysis of the Biomechanical Characteristics After Different Minimally Invasive Surgeries for Cervical Spondylopathy: A Finite Element Analysis

Efficacy and safety of percutaneous endoscopic cervical discectomy for cervical disc herniation: a systematic review and meta-analysis

Global Trends and Hotspots in Endoscopic Discectomy: A Study Based on Bibliometric Analysis

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