Middle–term Follow-up Results Of Full-endoscopic Anterior Transcorporeal Cervical Discectomy

Objective: To explore the middle-term follow-up clinical results and radiologic changes of patients with cervical intervertebral disc herniation(CIVDH)treated by full-endoscopic anterior transcorporeal cervical discectomy(FEATCD).Methods: 18 patients with CIVDH were enrolled under strict indications to perform FEATCD from Sep.2015 to Feb.2016.Males and females were 11 and 7 respectively.Average age and duration of symptoms were 54±12.24 years(range: 38-76 years)and 12.56±9.93 weeks(range: 2-23 weeks).4,7 and 7 patients in the herniated lesion of C3/4,C4/5 and C5/6 were seen respectively.Mean follow up was 14.44±2.18 months(range: 12-18 months).VAS(Visual Analog Scale),JOA(Japanese Orthopaedics Association Scores)and Nurick classification were adopted to evaluate the clinical results.Radiographic follow up included plain radiography,CT(Computed Tomography)and MRI(Magnetic Resonance Imaging).Lateral cervical spine radiographs were used to determine IDH(Intervertebral Disc Height)and the height of FSU(Functional Spinal Unit).The stability of cervical spine is judged by the flexion-extension radiograph.The details and union of the channel postoperative and the intraoperative decompression were discovered by CT and MRI respectively.Results: All the procedures were accomplished successfully by the same surgeon.Average operating time and blood loss was 69.83 ± 16.68 min and 12.56 ± 5.69 ml respectively.Drainage tube was unnecessary for any patient.Neck and arm pain got an immediate remission postoperative for all patients.Final JOA and VAS had a significant improvement compared to preoperative.Average VAS for neck and arm pain improved to 1.58±1.42 and 0.97±0.65 from 6.19±2.08 and 5.25±2.87 preoperative(P<0.05).Average JOA scores preand postoperative was 9.13±1.95 and 15.17±0.75 respectively(P<0.05).Mean IR(Improvement Rate of JOA)was 78.19 ± 10.23%.Average Nurick grade was 2.5 preoperative and 0.42 at final follow-up.Average IDH and FSU decreased to5.14±0.56 mm and 32.67±2.50 mm from 5.49±0.52 mm and 33.83±2.53mm(P>0.05).There were no surgery-related complications.Conclusion: FEATCD is a novel procedure which not only preserves cervical motion segment and decreases the damage to disc as much as possible but also owns some other merits,such as less trauma and low costs.But larger samples for longer follow up are necessary before FEATCD is widespread use,that will ascertain if there is decrease of IDH,instability of cervical spine and spontaneously intervertebral fusion.