A Study Of The Treatment For Cervical Spondylotic Radiculopathy About Using Full-Endoscopic Cervical Foraminotomy And Ge Zhi Tong Luo Fang

Objective:1 All cases for cervical spondylotic radiculopathy treated with Full-endoscopic Posterior Cervical Discectomy are compared with the cases treated with Anterior cervical discectomy and fusion.This is a preliminary study about the advantages and clinical curative effect of the Full-endoscopic Posterior Cervical Discectomy.2 The literature is strictly screened by retrieved all the famous paper databases at home and abroad.The literature included in the study was carried out by Meta-analysis.The results of the Meta-analysis provide evidence for the some conclusions of the clinical observation.Methods:1 The clinical observation:Select 63 cases of cervical spondylotic radiculopathy as the object of observation.All cases were divided into the full-endoscope minimally invasive surgery group and the ACDF operation group.The full-endoscope minimally invasive surgery group are all cases with Posterior-Percutaneous Endoscopic Cervical Disctomy(P-PECD).All cases oral Ge Zhi Tong Luo Fang after operation.Collect data about the time of hospitalization for two groups.The clinical observation was conducted in Preoperative,3 days after operation and 1 years after operation about VAS score,Total Tanaka Yasuku Score and The Neek Disability Index.At the last observation,we use evaluation of curative effect to observation of curative effect.2 Meta-analysis:We searched PubMed,Cochrane library,CNKI,Wanfang database,VIP resource platform,digital library and other well-known national science and technology database.We have retrieved 1297 relevant documents.We exclude 816 articles based on headlines,s and exclusion criteria.After reading the full text,we exclude 7 articles.Finally,only 4 liyeratures are included in the study:lliyerature about anterior-Percutaneous Endoscopic Cervical Disctomy and 3 liyeratures about Posterior-Percutaneous Endoscopic Cervical Disctomy.We evaluate the quality of the literature,the assessment of the risk bias and the rating of the evidence.We conducted a meta-analysis of the literature on the average time of operation,the amount of postoperative blood loss,the average time of hospitalization,complications,reoperation rate,patient satisfaction,et al.We come to the conclusion and this conclusion can support the conclusion of the clinical observation section.Results:1 The clinical observation:(1)(2)There were significant differences in the VAS score,Total Tanaka Yasuku Score and The Neek Disability Index about P-PECD.(3)There were significant differences in the VAS score,Total Tanaka Yasuku Score and The Neek Disability Index about ACDF.(4)There were no significant differences in the VAS score,Total Tanaka Yasuku Score and The Neek Disability Index in P-PECD group and ACDF group.The two methods of operation can improve the symptoms of the cervical spondylotic radiculopathy.(5)The good rate of curative effect was 93.75%in P-PECD group and 90.32%in ACDF group.Two groups have no significant differences.However,there were significant differences in the average time of hospitalization in P-PECD group and ACDF group,and the difference was statistically significant.2 Meta-analysis:(1)There were significant differences in the average operation time,the amount of intraoperative bleeding and the average time of hospitalization in the PECD and the ACDF.This conclusion has only general confidence level,because of the high heterogeneity.(2)There are no significant differences in complications,reoperation rates,patient satisfaction,adverse outcomes after operation,et al.This conclusion has high credibility because of the very low heterogeneity.(3)There is no significant difference in the improvement of cervical degeneration and pain.This conclusion is not determined because of the lack of more clinical reportsConclusion:1 ACDF can obviously relieve the pain of upper limb and neck of the patient,effectively restore the patient's limb function and improve the quality of life.It is a definite operative method.2 P-PECD can obviously relieve the pain of upper limb and neck of the patient,effectively restore the patient's limb function and improve the quality of life.It is a definite operative method.3 Although,P-PECD has the same clinical effect as the ACDF and there is no significant difference.However,the P-PECD can significantly shorten the patient's hospitalization time and effectively relieve the patient's economic pressure.4 A comprehensive analysis of the results of clinical observation and Meta-analysis:PECD and ACDF have the same curative effect.But,PECD has obvious advantages and may be more easily accepted by patients because of less operative trauma,shorter operative time,safer operation,less intraoperative bleeding and shorter bed time.