Clinical Observation Of Cervical Spondylotic Radiculopathy Treated By Different Approaches Of Percutaneous Endoscopy Combined With Geduan Shujing Decoction

Objective:This is a retrospective comparative study between the anterior and posterior approaches for PECD(Percutaneous Endoscopic Cervical Disectomy)in the treatment of cervical spondylotic radiculopathy.The objective is to explore the advantages and disadvantages of different approaches of PECD combined with Geduan Shujing Decoction in the treatment of cervical spondylotic radiculopathy and to provide references for clinical treatment strategy.Methods:Clinical observation of PECD on Cervical spondylosis:From April 2014 to April 2018,the patients with cervical spondylosis who underwent the treatment of PECD combined with Geduan Shujing Decoction(the anterior approach:15 patients,the posterior approach:19 patients)were selected from department of orthopedics in Jiangsu province hospital of integrated traditional Chinese and western medicine.The patients were followed up for 6 months.In this study,the operative time and the volume of disc removal were recorded and compared.VAS Score(upper limbs),VAS Score(neck)and Neck Disability Index(NDI)were studied preoperatively,1 week,1 month,3 months and 6 months postoperatively.Data were collected from the two groups and the differences between the two groups were compared.Results:We compared the VAS scores and NDI scores before surgery with the scores of 1 week,1 month,3 months and 6 months after surgery from patients who underwent A-PECD(Anterior Percutaneous Endoscopic Cervical Disectomy)and P-PECD(Posterior Percutaneous Endoscopic Cervical Disectomy)respectively.The mean operative time of A-PECD was shorter than the operative time of P-PECD(P<0.001),and AFECD had a relatively higher mean volume of the removed discs(P<0.001).The results indicated that intra-group comparison have significant differences(P<0.05).We also compared the VAS scores and NDI scores between two groups of patients,the results showed that there was no significant difference at each observation time point,and the P values were all larger than 0.05,which was not statistically significant.Conclusion:A-PECD and P-PECD combined with Geduan Shujing Decoction both have obvious good effects on improving pain and restoring cervical function.In addition,the percutaneous endoscopic cervical disectomy surgery has advantages of less trauma,lower cost and shorter hospitalization time than conventional surgery.Thus,it is a reliable surgical method for treating cervical spondylotic radiculopathy.According to the results of clinical observation,there is no significant difference of the advantages and disadvantages between A-PECD and P-PECD while the indications of different approaches should be taken seriously.