Observation Of The Affect On Cervical Spine Stability After Percutaneous Cervical Disc Nucleoplasty For Sympathetic Cervical Spondylosis

ObjectiveTo explore the clinical outcome and affect on cervical spine after percutaneous cervical disc nucleoplasty for sympathetic cervical spondylosis, provide certain theoretical basis for clinician to choose a proper method for treatment of sympathetic cervical spondylosis.MethodsForm October2011to December2012, strictly according to the inclusion and exclusion criteria selected forty-six patients with sympathtic cervical spondylosis to treated with percutaneous cervical disc nucleoplasty. Inclusion criteria:recurring dizziness or vertigo, flustered, chest tightness or blurred vision were main clinical manifestations, with or without symptoms as pain of shoulder or numbness of limb. Exclude eye-derived, brain-derived, ear-derived and vascular vertigo. All of the forty-six patients were underwent strictly conservative treatment for at least three months and failed. Exclusion criteria:disc-space narrowing caused by disc degeneration was up to50percent that the needle can’t pierce into disc-space. CT scans shows bony spinal stenosis, prolapsed intervertebral disc or intervertebral disc calcification, foramina or intervertebral joint hyperosteogeny. Combined with other spinal diseases such as vertebral fracture, tumour or tuberculosis. There were20males and26females with a mean age of46years (range34to69years). The disease duration ranged from6months to10years (median,5years), cervical3-4,4-5,5-6,6-7segments intervertebral disc was15,29,36,16case. Among these patients,1,2and3segmental percutaneous cervical disc nucleoplasty performed in6,30and10cases respectively. Pre-operation and different time of post operation Effect was evaluated according to VAS scores (Visual Analogue Scale) and Criterion using by Odom respectively. The affect on cervical stability was evaluated by vertebra angle displacement (AD) and vertebra horizontal displacement (HD).ResultThe follow-up time ranged from3to15months with an average of9months. The mean operative time was35,30and25min for3,2and1segmental percutaneous cervical disc nucleoplasty respectively; with a mean blood loss of5ml. there were no limbs activity obstacle, there were1case complicated with hematoma during operation and3cases complicated with needle channel pain post operation. There were no other serious complications. The mean JOA scores had decreased from6.9±0.9pre-operatively to2.3±0.6post-operatively. The results were17cases excellent,25cases good,3cases better and1case poor, satisfactory rate was91.30%. Paired T-test was adopted to compare the AD and HD values changes before and after surgery, and the result were no significant difference (P>0.05).ConclusionPercutaneous cervical disc nucleoplasty treatment for cervical spondylosis is effective, minimally-invasive and has no effect on the lumbar stability. And have advantages of less likely to injure nerve root and less risk of infection. It is worth extensive application in clinic.