STITCHLESS Percutaneous Endoscopic Cervical Discectomy

Nadkarni, Sunil; Kohli, Pavankumar; Patel, Billal; Gore, Satishchandra; Kulkarni, Bhagyashree S

doi:10.4103/ortho.ijortho_283_16

Cited by 8 publications

(4 citation statements)

References 22 publications

(57 reference statements)

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“…Besides, various minimally invasive techniques have been adopted to perform cervical laminectomy, such as microscopy or full endoscopy. However, CSM may be a relative contraindication to these techniques [19,20]. Recently, Lin et al reported a cervical laminectomy at C2/3 under full endoscopy with a good outcome [21].…”

Section: Discussionmentioning

confidence: 99%

Posterior Central Laminectomy for Bilateral Decompression under a Unilateral Biportal Endoscopic approach for Multi-segmental Cervical Stenosis: Anatomic and Technical note

Hu²,

Tang

et al. 2023

Preprint

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Background Cervical spondylotic myelopathy (CSM) caused by multi-segment cervical stenosis is a common spinal surgery disease with severe neurological dysfunction. The surgical goal was to achieve full canal decompression while minimizing damage to the normal structures. Unilateral biportal endoscopy (UBE), due to its good visualization, independent view-working portals, and wider instrument availability, can be utilized to efficiently and safely complete a laminectomy under endoscopy. Objective This study was to determine the efficiency and safety of a novel cervical laminectomy technique and introduce some new endoscopic anatomic concepts. Methods We report on 3 cases of multi-segment of cervical stenosis. The author attempted combinations of "laminectomy", "hemilaminectomy", and "ligamentum flavum resection" under UBE for different cervical cases. The postoperative neurological improvement and perioperative complications were used to determine the efficiency and safety. Results All 3 patients got significant improvement after surgery. And no complication was observed. This study described in detail the surgical steps and introduced new anatomic concepts that "infraspinous absence range (IS-AR)" and "ligamentum flavum-interspinous space (LF-IS space)". Conclusion Central laminectomy for bilateral decompression (CLBD) under UBE is an effective surgical method for the treatment of CSM caused by multi-segment cervical spinal stenosis. It can achieve the same decompression effect as traditional open cervical laminectomy while protecting the paraspinal muscles and posterior ligament complex which can avoid postoperative axial symptoms and cervical stiffness. However, due to the small size of the spinal canal and the small perturbation tolerance of the cervical spinal cord, the learning curve will be slightly high. China Clinical Trial registration number：ChiCTR2200065144.

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Section: Discussionmentioning

confidence: 99%

Posterior Central Laminectomy for Bilateral Decompression under a Unilateral Biportal Endoscopic approach for Multi-segmental Cervical Stenosis: Anatomic and Technical note

Hu²,

Tang

et al. 2023

Preprint

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“…One study included both anterior and posterior approaches (3.2%) 15 , 20 studies reported a posterior approach (64.5%), 6,7,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] and 10 studies reported an anterior approach (32.3%). 14,[34][35][36][37][38][39][40][41][42] All studies involved foraminotomy or discectomy by removing a disk fragment. Only one study reported fusion with an anterior approach using an intervertebral cage and iliac crest graft.…”

Section: Operative Techniquementioning

confidence: 99%

“…29 Three studies used local anesthesia or conscious sedation for the anterior approach. 37,38,42 Tzaan used both local and general anesthesia for a cohort of 86 patients who underwent an anterior approach. 36 Not all studies used intraoperative neuromonitoring.…”

Section: Operative Techniquementioning

confidence: 99%

Outcome of Anterior and Posterior Endoscopic Procedures for Cervical Radiculopathy Due to Degenerative Disk Disease: A Systematic Review and Meta-Analysis

Alomar

Maghrabi

Baeesa

et al. 2021

Global Spine Journal

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Study design: Systematic review and meta-analysis. Objectives: Cervical spine endoscopic discectomy and decompression have gained popularity in the last decade. This review aimed to shed light on the current outcomes of cervical spine endoscopic procedures for degenerative disc disease (DDD) and to calculate a pooled estimate of various outcome measures. Methods: We retrieved articles published in English related to endoscopic cervical spine procedures from 3 central databases from inception until September 2020. A subgroup analysis based on the anterior versus the posterior approach was performed. Results: Thirty-one articles fulfilled the eligibility criteria and included 1,410 patients. A successful outcome was observed in 91.3% (88.6-93.4%, P = 0.000). This percentage was lower for the anterior approach (89.6% [85.8-92.5%], P = 0.000) than for the posterior approach (94.2% [90.4-96.5%], P = 0.000). A higher percentage of poor outcomes was reported for the anterior approach (5.7% [3.2-10.1%], P = 0.000 vs. 2.3% [1-5.5%], P = 0.000 for the posterior approach). The overall complication rate was 7.2% (5.2-9.8%, P = 0.000). There was a slightly higher complication rate for the anterior approach (7.9% [4.5-13.3%], P = 0.000) than for the posterior approach (6.7% [4.4-10%], P = 0.000). The revision rate was 4.2% (2.6-6.8%, P = 0.000); and 4.2% (1.8-9.7%, P = 0.000) for the anterior approach and 4.00% (2.2-7.4%, P = 0.000) for the posterior approach. Conclusions: There is a higher success rate and lower complication rate with the posterior approach than with the anterior approach. However, high-quality randomized controlled trials are vital to evaluate the efficacy of these procedures.

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“…Space for nerve root is restored. Platelet rich fibrin plug was inserted after completion of procedure as there is evidence that it alleviates pain and helps in annular healing [7][8][9] . After procedure sterile dressing is applied without stitch.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Anterior Percutaneous Endoscopic Cervical Discectomy, a Stitchless and Bloodless Surgery: Clinical and Radiological Results

Nadkarni¹,

Sonawane²,

Gore³

et al. 2018

J Minim Invasive Spine Surg Tech

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Objective: Anterior cervical discectomy with fusion [ACDF] has been considered gold standard for cervical disc herniation over period of time. Anterior percutaneous endoscopic cervical discectomy [PECD] is minimally invasive technique without need for implant or bone graft in properly selected cases. In this study we present clinical and radiological results of anterior PECD. Methods: We retrospectively studied 31 patients treated with anterior PECD in our institute from January 2014 to December 2016. Patients' clinical data, visual analogue score [VAS], neck disability index [NDI] and radiographs were collected. Cervical lordosis angle, focal angle and disc height of involved segment were measured using Medsynapse software. Statistical analysis was performed using paired T test, chi square test. Results: There were 18 males, 13 females in this study. Mean follow up period was 28.5 months. VAS for neck pain reduced from 6.2±0.72 to 1.67±0.59; VAS for arm pain reduced from 7.25±0.71 to 1.5±0.61 at final follow up. NDI reduced from 64.7±7.62 to 13.48±5.42 at final follow up. Mean disc height of involved segment was 6.15 mm pre-operatively which reduced to 5.24 mm at final follow up showing reduction of 0.91 mm. This reduction is disc space is not clinically significant as VAS and NDI show significant fall. Cervical lordosis was well maintained which changed from 13.93°±3.7° to 15.58°±6.66°; [p-value is 0.060]. Pre-operative focal cervical angle of involved segment was 0.86°±1.66° which increased to 1.7°±1.81° at final follow up [p-value 0.0067]. Twenty out of 31 patients resumed their previous employment within 2 weeks. Conclusion: Anterior PECD is excellent minimally invasive technique for cervical disc herniation in properly selected cases. Patients have good functional and clinical recovery after this procedure.

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STITCHLESS Percutaneous Endoscopic Cervical Discectomy

Cited by 8 publications

References 22 publications

Posterior Central Laminectomy for Bilateral Decompression under a Unilateral Biportal Endoscopic approach for Multi-segmental Cervical Stenosis: Anatomic and Technical note

Posterior Central Laminectomy for Bilateral Decompression under a Unilateral Biportal Endoscopic approach for Multi-segmental Cervical Stenosis: Anatomic and Technical note

Outcome of Anterior and Posterior Endoscopic Procedures for Cervical Radiculopathy Due to Degenerative Disk Disease: A Systematic Review and Meta-Analysis

Anterior Percutaneous Endoscopic Cervical Discectomy, a Stitchless and Bloodless Surgery: Clinical and Radiological Results

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