Posterior percutaneous endoscopic cervical foraminotomy and discectomy for degenerative cervical radiculopathy using intraoperative O-arm imaging.

Abstract

IntroductionPosterior percutaneous endoscopic cervical foraminotomy and discectomy (P-PECD) is a minimally invasive technique for the treatment of degenerative cervical radiculopathy. The O-arm, an intraoperative mobile computed tomography (CT) scanner, may improve spine surgery outcomes.AimTo evaluate clinical outcomes of O-arm assisted P-PECD in patients with degenerative cervical radiculopathy.Material and methodsBetween January 2013 and January 2018, 32 patients with degenerative cervical radiculopathy who underwent P-PECD were followed up for 12 months. Their demographic, clinical and surgical data were reviewed retrospectively. All patients received intraoperative O-arm scanning to assess working cannula placement and decompression. The visual analogue scale (VAS), the neck disability index (NDI), and Odom’s criteria were used to evaluate clinical outcomes.ResultsCompared with preoperative values, mean NDI, neck-VAS, and arm-VAS scores were dramatically improved 1 week postoperatively, and the improvement was maintained for at least a year after surgery (from 27.6 ±10.5, 5.8 ±1.7, and 7.2 ±2.3 to 1.4 ±0.8, 1.1 ±0.8 and 0.9 ±0.6, respectively). According to Odom’s criteria, 27/32 patients (84.4%) reported excellent or good results. There were no permanent complications. One patient suffered from transient thumb weakness due to a cervical nerve root injury caused by the spinal needle.ConclusionsP-PECD aided by intraoperative O-arm imaging is a safe, effective, and minimally invasive procedure for treating degenerative cervical radiculopathy that can provide accurate cannula placement and thorough decompression.

Percutaneous endoscopic cervical foraminotomy as a new treatment for cervical radiculopathy

“…In this study, PECF data reported in 9 published studies were analyzed (Table 1 ). [ 13 – 21 ] Two of these 9 studies were prospective, while the other 7 studies were retrospective. A total of 486 patients (male:female = 230:256) were included in the study.…”

Application of anchoring of the projection point on the inner upper edge of the pedicle in minimally invasive posterior cervical foraminotomy (MI-PCF)

“…Hence, it can be di cult to nd and repeatedly con rm the V point of the surgical segment under C-arm uoroscopy during the operation. Researchers have proposed that O-arm uoroscopy could be used for 3D imaging to locate the V point during the operation, 21,22 and cervical spine lateral mass vertical anchoring has shown promise for use in surgical positioning. 14 The projection point on the inner upper edge of the pedicle is a bony structure, that does not change with dynamic changes in the position of the cervical spine during the operation.…”

Bilateral translaminar osseous-channel assisted percutaneous full-endoscopic ligamentectomy decompression for thoracic myelopathy due to ossification of the ligamentum flavum: a technical note.

“…Superior to the MED technique, a percutaneous spinal endoscopic procedure is widely applied in cervical and lumbar spine disorders to achieve excellent surgical visualization [ 15 ], an enlarged visual field due to the use of optical instruments, less iatrogenic trauma, and a faster postoperative recovery process. With growth of experience among spinal surgeons, improvement in surgical instruments, and the ability to achieve adequate bone and soft tissue resection, the scope of indications for the percutaneous spinal endoscopic technique has expanded [ 38 , 39 ].…”

“…With the advancement of surgical techniques and instruments, good results and advantages have been described for full-endoscopic discectomy techniques for lumbar stenoses and cervical spondylosis myelopathy [13][14][15]. However, few reports have explored the use of posterior percutaneous full-endoscopic ligamentectomy decompression (p-PELD) for TM caused by OLF.…”