Percutaneous Endoscopic Cervical Discectomy (PECD): An Analysis of Outcome, Causes of Reoperation

Oh, Hyeong Seok; Hwang, Byeong Wook; Park, Sang Joon; Hsieh, Chang Sheng; Lee, Sang Ho

doi:10.1016/j.wneu.2017.03.056

Cited by 29 publications

(22 citation statements)

References 17 publications

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“…The author referred a patient with postoperative headache, one case of iatrogenic damage of carotid artery, and a patient with recurrence after 2 years since the first procedure. No complications were reported by Oh et al (26), nevertheless, five patients had cervical stenosis and collapsed disc height, and 4 presented recurrences during the follow-up. Ruetten et al (27), in a prospective, randomized, controlled study of 49 patients treated by ACDF and 54 by anterior PECD, reported transient difficulty for swallowing in five cases of ACDF and in 2 of anterior PECD.…”

Section: Complicationsmentioning

confidence: 65%

“…A low rate of complications in patients underwent anterior PECD has been reported. However, they can be serious, and usually are access-related with an early presentation, such as vascular injury, prevertebral hematoma, swallowing dysfunction, esophageal injury, nerve injuries, wound infection, and cervical spinal cord compression (26). Tzaan (25) reported an incidence of 2% in 107 patients treated by the technique.…”

Section: Complicationsmentioning

confidence: 99%

“…Therefore, the working cannula should be located in the midline on AP projection and should not advance beyond the posterior vertebral line on lateral projection (22). Concerning the success rate, Ahn et al reported 88.3% of success in 111 subjects (21), Tzaan 91% in 107 patients (25), and 87% in 101 patients by Oh et al (26). The two major factors associated with excellent long-term outcome are unilateral radiculopathy symptoms and lateral disc herniation (21).…”

Section: Technical Commentsmentioning

confidence: 99%

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Percutaneous endoscopic cervical discectomy: a technical review

2018

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The treatment of cervical disc herniations has evolved in the last 2 decades. While the anterior cervical discectomy and fusion continues being the gold standard for the treatment of radicular pain triggered by cervical disc herniation, other surgical approaches have been developed. Percutaneous endoscopic cervical discectomy has demonstrated the ability to decompress the exiting nerve root and dural sac correctly and encouraging clinical outcomes has been reported in the literature. One of the most important advantages offered by the endoscopic technique is the capability to resolve the patient's symptoms without the need for interbody fusion. Also, a specific and selective decompression under continuous visualization with minimal surgery-related trauma can be achieved. There are two percutaneous endoscopic cervical discectomy approaches: anterior and posterior. The decision to perform each other depends on pathology site. However, the endoscopic technique requires previous surgical training, a steep learning curve, and proper patient selection. The development of new hardware such as endoscopes with better optics, lighting systems, and endoscopic surgical tools have allowed using endoscopic techniques in more complex cases. The objective of this review is the technical description of the anterior and posterior percutaneous endoscopic cervical discectomy.

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Section: Complicationsmentioning

confidence: 65%

Section: Complicationsmentioning

confidence: 99%

Section: Technical Commentsmentioning

confidence: 99%

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Percutaneous endoscopic cervical discectomy: a technical review

2018

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“…Endoscopy has been applied widely in spine surgery, including for the treatment of cervical decompression, lumbar stenosis, far-migrated LDH, and lumbar burst fracture. [ 4 , 13 ] However, PELD is a nonfusion surgery, and so recurrence of disc herniation can occur. The present patient experienced LDH recurrence twice after PELD.…”

Section: Discussionmentioning

confidence: 99%

“…Along with the evolvement of endoscopic surgical devices, the indications of spine endoscopy have broadened; recent studies have reported percutaneous endoscopic cervical discectomy, thoracic discectomy, lumbar stenosis discectomy, and even decompression after lumbar burst fracture. [ 4 – 6 ]…”

Section: Introductionmentioning

confidence: 99%

Recurrent lumbar disc herniation recurrence after percutaneous endoscopic lumbar discectomy

Wang¹,

Cong²,

Xu³

et al. 2018

Medicine

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Rationale:Lumbar disc herniation (LDH) is a degenerative disease and affects human health. Although percutaneous endoscopic lumbar discectomy (PELD) can redeem the living quality of patient with LDH rapidly, it appears weak to limit the recurrence rate of LDH.Patient concerns:A 52-year-old male suffered lower back pain and lower limb paralysis for 20 years. However, conservative treatment could not relieve above-mentioned symptoms after doing heavy labor.Diagnoses:Computed tomography (CT) revealed a disc fragment had migrated to the inferior edge of the L5 pedicle. Magnetic resonance imaging (MRI) demonstrated a type 2 Modic change (MC) at L5 and spinal canal stenosis at L4-L5. Based on these findings, the patient was diagnosed with L4-L5 disc herniation and secondary lumbar stenosis.Interventions:The patient underwent surgery twice for PELD at L4-L5 in 1 month. Symptoms were not improved effectively until the conventional posterior discectomy with fusion was performed.Outcomes:No signs of recurrence have been detected in 6 months of follow-up, except for mild lower back pain meeting the temperature change.Lessons:Rapid decompression and instant therapeutic effect do not mean extending the indications of PELD. It is unreasonable to revise the recurrent LDH or treat the primary LDH with PELD under inadequate preoperative assessment.

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