Percutaneous CESSYS Anterior Cervical Discectomy Cadaver Clinical Application Study

Objective: Through use CESSYS（Cervical Endoscopic SurgerySystem）to perform anterior percutaneous endoscopic cervical discectomy onthe adult cadaver specimens, then dissect and observe related indicators,discusses the feasibility, safety, minimally invasive Surgery and related clinicaloperation point. Methods: Select4(2males,2females)adult cadaver specimens,age between36and54years old, average age was42years old. Operatepercutaneous anterior percutaneous endoscopic cervical discectomy byCESSYS respectively for C3/4, C4/5, C5/6, C6/7, a total of16times. Select theclearance require surgery, and with the C arm X-ray machine positioningperspective, the operative approach with open surgery is consistent, namely forthe clearance of the sternocleidomastoid with shoulder tongue bone muscle,thyroid tongue bone muscle, with left hand forefinger inserted into the gapbetween vascular sheath, and visceral sheath, direct reach the anterior lateralvertebral bodies, and appropriate separation, with puncture needle punctureclose to the abdomen of finger, makes the puncture needle through the inside ofthe rim hook vertebral joints into the intervertebral disc. Insert the thread,andtake out the needle, make a transverse skin incision about5mm centered on thethread, With different diameter of expansion tube from small to large along thegodet screwing in slow gradually, use the trephine through the annular tubesinsert and cut fibrous rings when necessary, finally place work tube into the annular tubes,then placing CESSYS endoscope, removal of nucleus pulposuswith the nucleus pulposus clamp directly, the whole process of the operation iscompleted under the C arm X-ray machine to monitor and dynamic perspective.At the same time, record incision size, amount of removal nucleus pulposus,fluoroscopy number of C arm X-ray machine intraoperative, and observation ofimportant organization structure Whethe damage nearby surgical approach,including: carotid arteriovenous, esophagus, trachea, laryngeal recurrent nerve,vertebral artery, spinal cord, corresponding nerve root, and summarize theclinical relevant operation points. Use statistical software SPSS14.0to statisticsprocessing, the data is in the form of average±standard deviation. Results:1,The incision size is （5.60±0.17）mm.2, The amount of removal of nucleuspulposus in vision is （1.28±0.15）g.3, The perspective number is （9±1.15）n.4, Operation time (puncture time+nucleus pulposus removal time) is （104±11.41）min.5, Complications：16times of surgery， esophageal injury in2cases, no injury of carotid arteriovenous, trachea, laryngeal recurrent nerve andvertebral artery, spinal cord, the corresponding complications nerve root and soon.6,The key points of operation: Surgery should be carried out in accordancewith the related processes, especially the necessary is perspective of C armX-ray machine. Conclusion:1, Percutaneous CESSYS anterior Cervicaldiscectomy is feasible, and is one of the minimally invasive surgery treatmentfor cervical intervertebral disc herniation.2, Percutaneous CESSYS anteriorCervical discectomy in theory is minimally invasive.3, Percutaneous CESSYS anterior Cervical discectomy is relatively safe, but has certain risks, thepossibility of the injury of esophagus, trachea trauma, spinal cord, nerve rootand the vertebral artery. especially.4, Percutaneous CESSYS anterior Cervicaldiscectomy must follow the relevant operating points.