Percutaneous cervical discectomy: retrospective comparison of two different techniques

Ierardi, Anna Maria; Carnevale, Aldo; Cossu, Alberto; Coppola, Andrea; Fumarola, Enrico Maria; Garanzini, Enrico; Silipigni, Salvatore; Biasina, Alberto Magenta; Paolucci, Aldo; Giganti, Melchiore; Carrafiello, Gianpaolo

doi:10.1007/s11547-020-01133-x

Cited by 4 publications

(5 citation statements)

References 23 publications

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“…Finally, one study made a retrospective comparison in 50 patients who either underwent a PCN or a percutaneous cervical discectomy for a contained cervical disc herniation. 33 This study also showed that PCN had comparable results in terms of clinical success or complications, compared to cervical discectomy.…”

Section: Discussionsupporting

confidence: 55%

Long-Term Clinical Results of Percutaneous Cervical Nucleoplasty for Cervical Radicular Pain: A Retrospective Cohort Study

Rooij¹,

Gadjradj²,

Aukes³

et al. 2022

JPR

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Purpose Percutaneous cervical nucleoplasty (PCN) is a minimally invasive treatment for cervical radicular pain due to a disc herniation. Preliminary results show equivalent patient-reported outcomes of PCN as compared to conventional anterior cervical discectomy. However, there is a paucity of long-term outcome data. Therefore, the primary objective of this study is to investigate the long-term clinical results of PCN. Patients and Methods A retrospective analysis was conducted on patients who underwent PCN at a secondary referral center between 2010 and 2014. Before surgery and five days after surgery, numeric rating scales (NRS) for arm pain and neck pain and data on complications were collected. To determine long-term follow-up outcomes, patients were sent a questionnaire booklet containing the Core Outcome Measures Index-Neck (COMI-Neck), NRS for arm pain and neck pain, Likert-scales on patient satisfaction and questions regarding the incidence of reoperations and complications. Results The baseline characteristics were collected for 158 patients. At a median follow-up of 41.5 months (interquartile range (IQR) 27.0 to 57.5), data were available for 118 patients (74.7%). At short-term follow-up, patients that underwent PCN had a mean decrease of 3.0 on the NRS for arm pain (95% CI 2.5 to 3.6) compared to baseline, while at long-term follow-up, a mean decrease of 2.8 (95% CI 1.0 to 3.6) was observed. At the long-term follow-up, 67.8% of the patients were fully recovered from all symptoms and 93.3% remained satisfied with the PCN treatment results. The reoperation rate for recurrent disc herniation was 21.4% at long-term follow-up. Conclusion PCN appears to be a safe and effective treatment at short-term and long-term follow-up of a specific selection of cervical herniated discs, with an acceptable long-term reoperation rate. These study results suggest a potential role of PCN as a less invasive treatment option for cervical radicular pain due to a soft disc herniation, before anterior cervical discectomy should be considered.

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Section: Discussionsupporting

confidence: 55%

Long-Term Clinical Results of Percutaneous Cervical Nucleoplasty for Cervical Radicular Pain: A Retrospective Cohort Study

Rooij¹,

Gadjradj²,

Aukes³

et al. 2022

JPR

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“…Many reports, including retrospective, prospective, meta-analyses and randomized controlled studies, have indicated that PCN is a long-term safe and effective modality for treating contained CHIVD [ 7 , 16 , 17 , 23 ]. The effectiveness of PCN has been reported as not inferior to anterior cervical discectomy (ACD) or PCD [ 13 , 15 , 16 ]. Furthermore, a randomized controlled trial by Rooij et al also suggested that for single-level contained CHIVD, long-term effectiveness is not significantly different between ACD and PCN, and concluded that PCN can be a good alternative to ACD [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have reported PCN to be a safe and effective surgery over the long term [ 7 , 13 , 14 ]. Although other percutaneous techniques, such as percutaneous cervical discectomy (PCD), have been adopted by some physicians, the clinical results of PCN have not been reported to be inferior to those of PCD in several comparative studies [ 13 , 15 , 16 ]. To our knowledge, there is a limited number of studies that have evaluated the real benefits gained from PCN compared with CT, especially among these patients who are already indicated for surgery [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Analysis of the clinical and radiological outcomes of percutaneous cervical nucleoplasty: A case–control study

Chen

Chiu

et al. 2022

PLoS ONE

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Background Percutaneous cervical nucleoplasty (PCN) is a simple, safe, and effective treatment for contained cervical herniated intervertebral disc (CHIVD). However, few studies have compared the actual benefits of PCN against conservative treatment (CT), either clinically or radiographically. Purpose The present study sought to analyze and to compare the outcomes of symptomatic contained CHIVD treated with PCN or CT. Methods The present study was designed as a case–control comparative study. Patients who indicated for PCN after a failed CT for more than 6 months were recruited. After the exclusion of some patients who did not meet the selection criteria of the study, we finally enrolled 71 patients treated with PCN. In addition, another 21 patients who indicated for PCN but finally chose to receive CT continuously were also enrolled and categorized as the control group. All patients completed the 6-month follow-up. Pain levels and functional outcomes were evaluated pre- and post-operatively by assessing the visual analog scale (VAS), Oswestry Disability Index (ODI), and Neck Disability Index (NDI). Radiographic images of 72 of 104 intervened segments were collected to measure disc height and other cervical spinal alignments, such as range of motion, C2–7 Cobb’s angle, and C2–7 sagittal vertical axis. Results Compared with the CT group, the PCN group showed significantly better outcomes on VAS, ODI, and NDI at the 1-month post-operative follow-up, which continued through at least the 6-month follow-up (P < 0.01 for VAS and P < 0.05 for ODI and NDI). The mean disc height significantly decreased, from 6.04 ± 0.85 mm to 5.76 ± 1.02 mm, 3 months after PCN treatment (P = 0.003). However, the degree of disc height decrease did not correlate with the changes of the substantial VAS improvement. Conclusions To provide therapeutic benefits for symptomatic contained CHIVD patients after an invalid CT for 6 months, PCN seems to be a better option than CT. The reduced disc heights did not alter the clinical outcomes of PCN.

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“…We evaluated their preoperative and postoperative NRS scores, preoperative and postoperative NDI scores, and Macnab scores according to relevant questionnaires, and asked the time when their symptoms began to improve after surgery, the occurrence of postoperative complications, and the improvement in dizziness etc. The Macnab score 14 is the self-assessment result of the patient's curative effect, which is divided into four grades, which are Excellent: the symptoms of cervical spondylosis disappeared completely after treatment, and the activities were not restricted, which did not affect daily life and work; Good: After treatment, the symptoms of cervical spondylosis were signi cantly improved, and activities were occasionally limited, which did not affect daily life and work; Fair: After treatment, the symptoms of cervical spondylosis were improved, the activities were limited, and it was easy to relapse after exertion, and the impact on daily life and work was small; Poor: The symptoms of cervical spondylosis did not improve after treatment, and the activities were obviously limited, which seriously affected daily life and work. The score was the comprehensive evaluation of the e cacy of the treatment, including the pain, function and daily experience of the cervical spine and upper limbs.…”

Section: Methodsmentioning

confidence: 99%

Intervertebral disc approach versus nerve root approach in the treatment of cervical spondylotic radiculopathy: a cohort study

Kong

Yang

Cai

et al. 2022

Preprint

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Background With the gradual development of minimally invasive surgery, the treatment of cervical spondylosis is becoming more sophisticated and diversified. However, there was no previous study on the efficacy of intervertebral disc approach and nerve root approach for cervical spondylotic radiculopathy. This trial aims to provide a basis for the clinical treatment of cervical spondylotic radiculopathy by comparing the advantages and disadvantages of the two cutting-edge surgical methods. Methods Collect relevant information of patients with cervical spondylotic radiculopathy in 3 hospitals and follow up on the postoperative curative effect of the two surgical methods. The improvement of pain and numbness symptoms and cervical spine function were evaluated by NRS, NDI, and Macnab scores, and the postoperative recovery time and the improvement rate of dizziness were comprehensively analyzed. After that, we analyzed the mechanism of the different curative effects of the two surgical methods and found the different characteristics of their therapeutic targets. Results Compared with before treatment, the NRS scores and NDI scores of the two groups of patients were significantly decreased after treatment (P<0.05). The postoperative NRS score and NDI score of the plasma group were significantly lower than those of the radiofrequency group (2 to 3, 10 to 13, P<0.01), and the therapeutic efficiency of the plasma group was higher than that of the radiofrequency group (82% to 61%, P<0.01). The improvement rate of dizziness symptoms in the plasma group was higher than that in the radiofrequency group (79% to 43%, P<0.05), however, the proportion of people in the radiofrequency group whose symptoms improved within one week after the operation was significantly higher than that in the plasma group (51% to 24%, P<0.01). Conclusions Both treatment options could effectively relieved the symptoms of patients with cervical spondylotic radiculopathy, but the degree of relief was different. Compared with cervical nerve radiofrequency, cervical intervertebral disc plasma decompression can better relieve upper extremity symptoms in patients with cervical spondylotic radiculopathy, promote the recovery of cervical spine function and improve cervical spondylosis-related dizziness symptoms, which may be closely related to the reduction of the pressure on the internal tissues of the cervical spine.

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Percutaneous cervical discectomy: retrospective comparison of two different techniques

Cited by 4 publications

References 23 publications

Long-Term Clinical Results of Percutaneous Cervical Nucleoplasty for Cervical Radicular Pain: A Retrospective Cohort Study

Long-Term Clinical Results of Percutaneous Cervical Nucleoplasty for Cervical Radicular Pain: A Retrospective Cohort Study

Analysis of the clinical and radiological outcomes of percutaneous cervical nucleoplasty: A case–control study

Intervertebral disc approach versus nerve root approach in the treatment of cervical spondylotic radiculopathy: a cohort study

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