| BackgroundCervical spondylotic radiculopathy is the orthopedic common and frequently-occurring disease, because of the social development, it presents the younger trend, mainly due to long-term improper posture of 30 to 50 years old people, the ratio of male to female was 2:1, it accounts for 50% to 60% of all types of cervical spondylosis.Before the advent of the minimally invasive technique, the treatment of cervical spondylotic radiculopathy include conservative therapy and surgical therapy, and the application of minimally invasive techniques, especially the percutaneous cervical disc nucleoplasty, provides a new way to treat the disease, also offers the orthopaedic surgeon a kind of choice in treatment of disease.ObjectiveTo observe the mid-term outcome of percutaneous cervical disc nucleoplasty (PCDN) for cervical spondylotic radiculopathy.Method339 patients with cervical spondylotic were treated by PCDN in our hospital from April 2010 to June 2013,231 of whom were diagnosed as cervical spondylotic radiculopathy,135 of them were followed up for 2-5.08 years.There were 41 males and 94 females with the mean age of 54.76±8.48 years (range,27±76 years old).Single level was performed in all patients.The Japanese Orthopedic Associations of Yasuhisa Tanaka 20 score, VAS and the modified MacNab score were used to evaluate the result at 1 month,3 months,6 months,12 months,24 months, final follow-up after surgery respectively.ResultThe group of 135 patients with a total of 135 intervertebral disc punctured successfully, no postoperation nerve root injury, vessels rupture, the puncture point infection and complications such as infection of intervertebral disc. The excellent and good rate at 1 month, 3 months,6 months,12 months,24 months, final follow-up after operation were 47.4%, 57.0%,65.9%,65.2%,61.5% and 60.7%, which showed significant difference compared with 1 month,3 months(P<0.05), the effective rate were 77.0%,78.5%,77.0%,74.8%,71.9% and 70.4%.Preoperation VAS score average 7.42±2.13, postoperation VAS score average were 2.82±2.07,2.43±2.12,1.95±2.35,1.93±2.38,2.18±2.57,2.29±2.59 respectively at 1 month,3 months,6 months,12 months,24 months, final follow-up.From 1 month to the last follow-up compared respectively with the preoperation,and from 3 month to the last follow-up compared respectively with 1 month, and from 6 month to 12 month compared respectively with 3 month, VAS score were statistically significant, as well as the last follow-up compared with 12 month, VAS score was statistically significant, but from 24 month to the last follow-up compared with 3 month and 6 month respectively, VAS score was not statistically significant, so does between 24 month and the last follow-up.According to the modified MacNab therapeutic evaluation criteria, the excellent and good rate at 1 month,3 months,6 months,12 months,24 months, final follow-up after operation were 64.4%、65.2%、70.4%、67.4%、64.4% and 63.0%, the effective rate were 85.2%、85.2%、83.0%、80.7%、78.5% and 77.0%.ConclusionPercutaneous cervical disc nucleoplasty can obviously improve the symptoms of patients of cervical spondylotic radiculopathy, such as pain, numbness of neck, shoulder and upper limb, as well as improve the patient’s daily life.Although there are some patient’s symptoms recurrence after postoperation, the majority of patients after PCDN obtained satisfactory curative effect at mid-term, but how is the long-term curative effect like, then we need to continue to investigate in the future.The outcome of percutaneous cervical disc nucleoplasty for cervical spondylotic radiculopathy have relationship with age and course of disease. |
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