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| Preoperative precise localization of cervical disc herniation by brachial plexus MRN in the treatment of cervical spondylotic radiculopathy |
| HUANG Zhen, LI Yuefei, BI Jingwei, REN Jiabin, LI Rui, LIU Xin, SUN Ning, SUN Zhaozhong* |
| Department of Spinal Surgery, Binzhou Medical University Hospital, Binzhou 256603, Shandong,P.R. China |
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Abstract Objective To analyze the clinical efficacy of precise decompression in posterior percutaneous endoscopic cervical discectomy (PPECD) by locating the herniated cervical disc through brachial plexus magnetic resonance neurography (MRN). Methods Thirty-nine patients with cervical spondylotic radiculopathy (CSR) who underwent PPECD were divided into MRN group and conventional group according to whether brachial plexus MRN was performed before operation. There were 18 patients in MRN group and 21 patients in control group. The operation time, bleeding volume, fluoroscopy times during operation, incidence of upper limb numbness and muscle weakness after operation, the longest diameter of left and right bone window and the longest diameter of upper and lower bone window were recorded. The VAS and JOA value of preoperative, postoperative, 6 months after operation and 12 months after operation were compared between the two groups. C2～C7 Cobb angle, height of intervertebral space at operative level were recorded. Results The operation time, intraoperative bleeding volume, intraoperative fluoroscopy times in the MRN group were better than those in the conventional group(P<0.001). The changes of JOA value, VAS value and C2～C7 Cobb angle in 6 months and 12 months after operation were significantly improved compared with those before operation(P<0.05). Conclusion Preoperative brachial plexus MRN precise location of cervical disc herniation could reduce the damage to zygapophysial joint and other structures caused by grinding bone window in PPECD, avoid the injury of cervical nerve and dura mater caused by searching for herniated cervical intervertebral disc, reduce intraoperative bleeding, fluoroscopy times and operation time, and obtain the best result with less trauma. Surgical effect, operation safety is higher, patients recover faster after operation.
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Received: 26 August 2019
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