Myelopathic signs and functional outcome following cervical decompression surgery: a proposed myelopathy scale

et al. 2020

J Orthop Surg Res

Background Percutaneous spinal endoscopy is a new type of surgery for the treatment of cervical disc herniation. It can avoid the complications of the classic anterior cervical discectomy and fusion (ACDF) approach and the risk of adjacent spondylosis. How can we effectively improve patients’ awareness of spinal endoscopy and their election of endoscopic techniques? Objective To analyze the compliance and clinical effect of the integrated management of the whole process in the choice of percutaneous full-endoscopic surgery for patients with cervical disc herniation. Methods Retrospective analysis of 72 patients with cervical disc herniation undergoing surgery in our hospital from August 2015–August 2017 was performed. The whole-process integrated management model was used for all the patients. The 36 patients in the experimental group were treated by percutaneous full-endoscopic cervical discectomy, and the 36 patients in the control group were treated by ACDF. The postoperative feeding time, time to get out of bed, length of hospital stay, compliance, clinical efficacy, and recurrence rate of neck pain were observed. Changes between the preoperative and postoperative pain visual analog scale (VAS) scores and neurological function Japan Orthopaedic Association (JOA) scores were assessed. Results The postoperative feeding time in the experimental group was 8.319 ± 1.374 h, the postoperative time to get out of bed was 16.64 ± 3.728 h, and the hospitalization time was 6.403 ± 0.735 days. The excellent and good clinical efficacy rate was 91.67%, the compliance rate was 88.89%, and the neck pain recurrence rate was 5.56%. The postoperative feeding time in the control group was 26.56 ± 9.512 h, the postoperative time to get out of bed was 45.06 ± 9.027 h, and the length of hospital stay was 8.208 ± 0.865 days. The excellent and good clinical efficacy rate was 88.89%, the compliance rate was 69.4%, and the neck pain recurrence rate was 8.33%. There was no significant difference between the two groups in the excellent efficacy rate and the neck pain recurrence rate, p > 0.05. The compliance rate in the experimental group was better than that in the control group, and the difference was statistically significant, p < 0.05. The hospitalization time of the experimental group was significantly lower than that of the control group, and the difference was statistically significant, p < 0.05. The postoperative VAS scores and JOA scores of the two groups were significantly better than the preoperative scores, and the difference was statistically significant, p < 0.05; there was no significant difference between the two groups, p > 0.05. Conclusion The integrated management of the whole course can effectively improve the compliance of patients with cervical disc hern...

Section: Discussionmentioning

confidence: 99%

Analysis of compliance and efficacy of integrated management of whole process in the choice of percutaneous full-endoscopic surgery for patients with cervical disc herniation

et al. 2020

J Orthop Surg Res

“…However, long-term clinical follow-up has revealed concerns related to the complications associated with this approach and the acceleration of degeneration of the adjacent segments, in addition to the reappearance of related symptoms and signs of cervical spondylosis [5][6][7] . Full-endoscopic spinal surgery not only avoids the de ciency of open surgery but also fully preserves the biomechanical stability of the spine [28,29] . However, patients and nonspecialists have little knowledge of modern spinal full-endoscopic surgery techniques, and they are reluctant to undertake full-endoscopic treatment at an early stage.…”

Section: Discussionmentioning

confidence: 99%

Analysis of compliance and efficacy of integrated management of whole process in the choice of percutaneous full-endoscopic surgery for patients with cervical disc herniation

et al. 2020

Preprint

Background: Percutaneous spinal endoscopy is a new type of surgery for the treatment of cervical disc herniation. It can avoid the complications of the classic anterior cervical discectomy and fusion (ACDF) approach and the risk of adjacent spondylosis. How can we effectively improve patients' awareness of spinal endoscopy and their election of endoscopic techniques?Objective: To analyze the compliance and clinical effect of the integrated management of the whole process in the choice of percutaneous full-endoscopic surgery for patients with cervical disc herniation.Methods: Retrospective analysis of 72 patients with cervical disc herniation undergoing surgery in our hospital from August 2015–August 2017 was performed. The whole-process integrated management model was used for all the patients. The 36 patients in the experimental group were treated by percutaneous full-endoscopic cervical discectomy, and the 36 patients in the control group were treated by ACDF. The postoperative feeding time, time to get out of bed, length of hospital stay, compliance, clinical efficacy, and recurrence rate of neck pain were observed. Changes between the preoperative and postoperative pain visual analog scale (VAS) scores and neurological function Japan Orthopaedic Association (JOA) scores were assessed.Results: The postoperative feeding time in the experimental group was 8.319 ± 1.374 hours, the postoperative time to get out of bed was 16.64 ± 3.728 hours, and the hospitalization time was 6.403 ± 0.735 days. The excellent and good clinical efficacy rate was 91.67%, the compliance rate was 88.89%, and the neck pain recurrence rate was 5.56%. The postoperative feeding time in the control group was 26.56 ± 9.512 hours, the postoperative time to get out of bed was 45.06 ± 9.027 hours, and the length of hospital stay was 8.208 ± 0.865 days. The excellent and good clinical efficacy rate was 88.89%, the compliance rate was 69.4%, and the neck pain recurrence rate was 8.33%. There was no significant difference between the two groups in the excellent efficacy rate and the neck pain recurrence rate, p>0.05. The compliance rate in the experimental group was better than that in the control group, and the difference was statistically significant, p<0.05. The hospitalization time of the experimental group was significantly lower than that of the control group, and the difference was statistically significant, p<0.05. The postoperative VAS scores and JOA scores of the two groups were significantly better than the preoperative scores, and the difference was statistically significant, p<0.05; there was no significant difference between the two groups, p>0.05.Conclusion: The integrated management of the whole course can effectively improve the compliance of patients with cervical disc herniation receiving endoscopic treatment, yield the same treatment effect as the classic operation, shorten the hospitalization time, speed up the turnover of hospital beds, and improve satisfaction with medical quality and is worthy of clinical application.

“…However, the long-term clinical follow-up found that the associated complications of approach and the acceleration of degeneration of adjacent segments were the clinical concerned, and the related symptoms and signs of cervical spondylosis appeared again [5][6][7] . The development of spinal full-endoscopy not only avoided the deficiency of open surgery, but also fully preserve the biomechanical stability of the spine [28,29] . However, patients and non-specialists have little knowledge of modern spine fullendoscopic techniques, they are reluctant to undergo full-endoscopic treatment at an early stage.…”

Section: Discussionmentioning

confidence: 99%

Analysis of compliance and efficacy of integrated management of whole process in the choice of percutaneous full-endoscopic surgery for patients with cervical disc herniation

Kong

et al. 2020

Preprint

Background : Percutaneous spinal endoscopy technique is a new type of surgery for the treatment of cervical disc herniation. It can avoid the complications of classic ACDF approach and the risk of adjacent spondylosis. How to effectively improve patients' awareness of spinal endoscopy and choose to receive endoscopic techniques? Objective: To analyze the compliance and clinical effect of the integrated management of whole process in the choice of percutaneous full-endoscopic surgery for patients with cervical disc herniation. Methods: Retrospective analysis of 72 patients with cervical disc herniation undergoing surgery in our hospital in August 2015~ August 2017, all of them carried out the whole process integrated management mode, 36 patients in the experimental group were treated by percutaneous full-endoscopic cervical discectomy, and 36 patients in the control group were treated by anterior cervical discectomy and fusion(ACDF). The postoperative feeding time, time to get out of bed, length of hospital stay, compliance, clinical efficacy, and recurrence rate of neck pain were observed. And changes in pain visual analogue score (VAS) and neurological function JOA score of preoperative and postoperative. Results: The postoperative feeding time in the experimental group was 8.319 ± 1.374 hours, the postoperative bedtime was 16.64 ± 3.728 hours, and the hospitalization time was 6.403 ± 0.735 days; The clinical excellent and good rate was 91.67%, the compliance rate was 88.89%, and the neck pain recurrence rate was 5.56%. The postoperative feeding time in the control group was 26.56 ± 9.512 hours, the postoperative bedtime was 45.06 ± 9.027 hours, and the length of hospital stay was 8.208 ± 0.865 days; The excellent and good rate was 88.89%, the compliance rate was 69.4%, and the neck pain recurrence rate was 8.33%. There was no significant difference between the two groups in the excellent treatment rate and the recurrence rate of neck pain, p> 0.05; The compliance rate of the experimental group was better than the control group, and the difference was statistically significant, p <0.05; the hospitalization time of the experimental group was significantly lower than that of the control group, the difference was statistically significant, p<0.05. The postoperative VAS scores and JOA scores of the two groups were significantly improved compared with preoperative, the difference was statistically significant, p<0.05; and there was no significant difference between the two groups, p> 0.05. Conclusion : The integrated management mode of the whole course can effectively improve the compliance of patients with cervical disc herniation receiving endoscopic treatment, obtain the same treatment effect as the classic operation, shorten the hospitalization time, speed up the turnover of hospital beds, improve the satisfaction of medical quality, and be worthy of clinical application.