The Clinical Study Of Percutaneous Transforaminal Endoscopic Cervical Discectomy For Single-level Cervical Spondylotic Radiculopathy

Objective To determine the safety and efficacy of percutaneous transforaminal endoscopic cervical discectomy(PTECD)in the treatment of single-level cervical spondylotic radiculopathy(CSR)and its influence on cervical activity.Methods A retrospective review was performed on 50 patients with single-level cervical spondylotic radiculopathy between August 2016 and August 2018 in ChiFeng city hospital.Divided into two groups according to different surgical methods:the experimental group(treated by percutaneous transforaminal endoscopic cervical discectomy)and the control group(treated by anterior cervical discectomy and fusion).Experimental group:23 cases,13.04% at C3/4,21.74% at C4/5,30.44% at C5/6,34.78% at C6/7.Control group:27 cases,14.82% at C3/4,22.22% at C4/5,33.33% at C5/6,29.63% at C6/7.The duration time of operation、length of the incision and intraoperative blood loss were recorded.VAS(visual analogue score)、NDI(neck disability index)、range-of-motion of cervical overall and adjacent segments were evaluated preoperative,3 months and 12 months postoperative.The Mos 36-item Short Form Health Survey(SF-36)scores was used in the assessment of preoperative and 12 months postoperative.Intervertebral height and cervical lordosis were evaluated preoperative and 12 months postoperative in the experimental group.The efficacy of PTECD was evaluated by the comparison of all the above indicators.Results During follow-up period,no one was lost in 50 patients.The length of the incision,the intraoperative blood loss were statistically significant(p<0.05).However,there was no significant difference in the duration time of operation(p>0.05).The VAS score and NDI index were evaluated before and 3 months after operation and 12 months after operation,There was no significant difference between the two groups.The two procedures were consistent in postoperative pain and functional remission.The SF-36 scores of the two groups were improved at 12 months after operation,but the scores of the experimental group were higher than those of the control group,and the differences were statistically significant(p<0.05).The range-of-motion of adjacent upper and lower segments in the experimental group was smaller than that in the control group at 3 months and 12 months postoperation,and the difference was statistically significant(p<0.05).The range-of-motion of overall cervical was significantly higher than that of the control group at 3 months after operation(p<0.05).There was no significant difference in the range-of-motion of overall cervical between the two groups at 12 months after operation(p>0.05).In the experimental group,there was no difference in the intervertebral height at preoperation and 12 months postoperation.But there was a statistically significant change in cervical lordosis(p<0.05).Conclusion Percutaneous transforaminal endoscopic cervical discectomy is a safe and effective minimally invasive treatment for single-level cervical spondylotic radiculopathy.It can safely and effectively relieve the compression of nerve roots while maintaining the stability of the cervical vertebra and is worth promoting.