Clinical Comparative Study Of Posterior Endoscopic Cervical Discectomy And Percutaneous Cervical Disc Nucleoplasty In The Treatment Of Cervical Spondylotic Radiculopathy

Objective:To compare the clinical efficacy,general indices and complications of posterior percutaneous endoscopic cervical discectomy（PPECD）with percutaneous cervical nucleoplasty（PCN）in the treatment of cervical spondylotic radiculopathy（CSR）diagnosed as soft-disc herniation to provide a reference for the choice of clinical treatment modality.Methods: Sixty patients with neurogenic cervical spondylosis admitted to the Pain Department of the First Affiliated Hospital of Anhui Medical University from June 2019 to December 2020 were selected and divided equally into two groups: 30 patients in group A,who underwent PPECD,and 30 patients in group B,who underwent PCN.The improvement of pain was assessed by visual analogue scale（VAS）before surgery,1 day after surgery,7 days after surgery,1 month after surgery,3 months after surgery,6months after surgery and 1 year after surgery,and the recovery of cervical spine function was assessed by Neck disability index（NDI）and Japanese orthopaedic association（JOA）.And the surgical efficacy was evaluated at the final follow-up using the modified Mac Nab criteria.Surgical complications were observed and recorded,as well as the length of surgery,intraoperative pain and general indicators of hospitalization costs.Results: There was no significant difference in the basic conditions of the two groups before surgery;VAS score and NDI index decreased significantly（P<0.05）and JOA score increased significantly（P<0.05）compared with those before surgery at each follow-up time point in both groups;VAS score was lower in group A than in group B at6 months and 1 year after surgery,and the difference was statistically significant（P<0.05）,and the improvement of pain in group A was better than that in group B;JOA score and NDI index at 1 year after surgery were statistically significant（P<0.05）.The differences between groups in JOA score and NDI index at 1 year after surgery were statistically significant（P<0.05）,and the functional recovery in group A was better than that in group B.At the final follow-up,the excellent rate in group A was significantly higher than that in group B（P<0.05）.No serious complications occurred in both groups,but the length of surgery and the general index of intraoperative pain score were less in group B than in group A（P<0.05）,and the hospitalization cost was comparable in both groups（P>0.05）.Conclusion: Both PPECD and PCN can effectively treat CSR.PCN has the advantage of shorter operative time and less intraoperative pain,but the intermediate and long-term outcomes after PPECD are better than PCN.