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| Selection of surgical procedures between PPECD and TcPECD |
| SUN Ning, HUANG Zhen, LIU Xin, LI Rui, REN Jiabin, LI Yuefei, SUN Zhaozhong |
| Department of Spinal Surgery,Binzhou Medical University Hospital,Binzhou 256603,P.R.China |
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Abstract Objective To analyze operative efficacy and complications of posterior percutaneous endoscopic cervical discectomy (PPECD) and transcorporeal percutaneous endoscopic cervical discectomy (TcPECD),providing a basis for selection of surgical procedures.Methods Totally 38 patients with single segment cervical spondylosis were treated in our department from May 2014 to April 2015. There were 32 cases of PPCED in group A including 20 female cases and 12 male cases, and 6 cases of TcPECD in group B including 4 female cases and 2 male cases.The operation time, the height of the responsible intervertebral space before and after operation,postoperative complications,hospital stay and other clinical parameters were counted.Visual analogue score was used to evaluate the incision pain one day,two days and three days after operation, and the neck pain and upper extremity radiation pain one month, three months, six months and twelve months after operation.The cervical spine of all patients was examined by CT+ and MRI in the follow-ups one month, three months, six months and twelve months after operation.Results ]The VAS scores of postoperative neck pain and upper extremity radiation pain in both groups were lower than those before operation. There was no significant difference between the two groups one month, three months, six months and twelve months after operation (P＞0.05). VAS scores of the incision pain of the two groups decreased to different degrees one day to three days after operation, and there was no significant statistical difference. Postoperative imaging showed that the operation site was accurate, the height of intervertebral space in group A had no significant change after surgery, while that in group B was significantly lower than that before surgery.The difference between the two groups was statistically significant. In group A, there were 4 cases of skin hypoesthesia, and 1 case of swelling of left thumb and index finger;while in group B 1 case of slight collapse of vertebral body and 3 cases of reduction of intervertebral space.Conclusion The two methods of operation are satisfactory.TcPECD is more suitable for cervical spondylotic myelopathy with central protrusion (free) from the intervertebral space horizontally upward or downward.PPECD is more suitable for cervical spondylotic myelopathy with nerve root type and paracentral type.
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Received: 23 July 2018
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