Clinical effect of channel assisted cervical key hole technology combined with ultrasonic bone osteotome in the treatment of single segment cervical spondylotic radiculopathy

Abstract

ObjectiveTo explore the clinical effect and operating skills of channel assisted Cervical Key Hole technology combined with Ultrasonic Bone Osteotome (CKH-UBO) in the treatment of single segment cervical spondylotic radiculopathy (CSR).MethodsFrom June 2018 to June 2020, 14 patients diagnosed with CSR and treated with channel assisted CKH-UBO were collected. The duration of the disease, the length of the incision, the operation time, the amount of bleeding during the operation, the length of hospitalization and the complications were recorded. The Range Of Motion (ROM) and the stability of the surgical segment were recorded before and after the operation. Visual analog scale (VAS), neck disability index (NDI) and modified macnab efficacy evaluation criteria were used to evaluate the surgical efficacy.ResultsThe operative segments of the enrolled patients were all lower cervical vertebrae. The average incision length was 2.0 ± 0.1 cm, the operation time was 42.2 ± 5.7 min, the intraoperative bleeding volume was 32.7 ± 4.1 ml, and the hospital stay was 5.6 ± 1.2 days. There was no difference in ROM between preoperative and 3 months and 1 year after operation (P > 0.05), and all patients did not have segmental instability. The VAS scores of neck pain before surgery, 3 days after surgery, 3 months after surgery, and 1 year after surgery were 5.6 ± 1.2, 1.6 ± 0.6, 1.1 ± 0.7, 0.6 ± 0.5, and the VAS scores of upper limb pain were 6.2 ± 1.2, 1.7 ± 0.7, 1.1 ± 0.6, 0.6 ± 0.5. The NDI scores of upper limb pain before surgery, 3 days after surgery, 3 months after surgery, and 1 year after surgery were 36.7 ± 3.5, 9.8 ± 2.4, and 3.9 ± 1.5, 1.8 ± 1.0, The VAS and NDI scores at all follow-up time points after operation were significantly lower than those before operation (P < 0.001). One year after operation, the curative effect was evaluated according to the modified macnab evaluation standard, and the excellent and good rate was 100%. The complication rate was 6.25%.ConclusionChannel assisted CKH-UBO for single segment CSR has the advantages of short operation time, reliable clinical effect, high safety and low complication rate, which is worthy of clinical promotion.

Channel-assisted cervical key hole technology combined with ultrasonic bone osteotome versus posterior percutaneous endoscopic cervical foraminotomy: a clinical retrospective study

“…The combination of the ultrasonic bone scalpel and the large channel maximizes the safety of UBO and eliminates the need for endoscope installation, further enhancing efficiency. Under the large channel, electric surgical knives and tools of the same size as those used in open surgery can be used to quickly remove soft tissues around the facet joints and vertebral plate edge [ 16 ], expanding the operative field and workspace. Simultaneously, the surgeon can manipulate the ultrasonic bone scalpel with one hand while using a retractor with the other hand to maintain a clear surgical field of view.…”

“…Importantly, with the introduction of UBO, the combination of a large channel approach and a microscope is no longer mandatory. A surgical approach using a large channel combined with UBO has been developed, potentially significantly improving the efficiency of MIS-PCF surgery [ 16 ].…”

Evaluation of Safety and Efficacy of Preoperative Coronal MRI-Guided Minimally Invasive Surgery for Cervical Spondylotic Radiculopathy

“…In a report by Zhang et al [ 29 ], of 42 patients with CSR who underwent key-hole surgery with O-arm navigation assistance, 38 achieved favorable treatment outcomes. Liu et al used ultrasonic bone osteotome as a supplementary approach in conjunction with key-hole surgery [ 7 ]. Previous reports have described the use of the novel Delta system for key-hole surgery [ 30 ].…”

“…The aforementioned studies have demonstrated favorable clinical outcomes in terms of improving accuracy, relieving nerve compression, and reducing surgical time. However, they also have challenges such as complex utilization procedures, steep learning curves [ 7 ], high probability of postoperative complications [ 30 ], intraoperative radiation exposure [ 29 ], and inability to enhance the preoperative diagnostic confirmation rate of nerve root-type cervical spondylosis [ 7 , 29 , 30 ]. As a result, widespread adoption and application have not been achieved.…”

“…However, cervical fusion can impact the mobility of the treated cervical segment and can potentially lead to adjacent segment disease [ 6 ]. As the field of minimally invasive spine surgery continues to advance at a rapid pace, the cervical key-hole technique has been widely used in the treatment of CSR, owing to minimal trauma, faster recovery, and maintenance of the stability of the cervical spine in the operative segment [ 7 ]. The key steps in key-hole surgery involve the exploration of the protruding intervertebral disc and the relief of compression on the responsible segmental nerve root.…”