Percutaneous posterior full-endoscopic cervical foraminotomy and discectomy: a finite element analysis and radiological assessment

Ke, Wencan; Zhi, Jinggang; Hua, Wenbin; Wang, Bingjin; Lu, Shuaicheng; Fan, Liancheng; Li, Li; Yang, Cao

doi:10.1080/10255842.2020.1765162

Cited by 8 publications

(6 citation statements)

References 29 publications

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“…[11,12] To a certain extent, it has affected the clinician's choice of treatment options for cervical spondylotic myelopathy. [13][14][15][16] In order to solve this problem, some scholars proposed to use somatosensory-evoked potential amplitude and latency to assess patients after spinal cord surgery to a The main basis for evaluating the effect of surgical treatment is that the amplitude of the evoked potential can determine the number of neurons in response to the stimulus (when the number of neurons in response to the stimulus decreases, the amplitude curve of the evoked potential decreases) and then determine the electrical conductivity of the injured neurons to the evoked potential when the spinal cord is compressed [20][21][22], which indirectly reflects the number of spinal cord nerve injuries in the patients. The literature shows that the level of SEP amplitude combined with morphological testing can more accurately determine the patient's injury and recovery [23][24][25].…”

Section: Discussionmentioning

confidence: 99%

[Retracted] Clinical Application of Evoked Potentials in the Operation of Cervical Spondylotic Myelopathy with Different Imaging

Ding

Zong

Zong-jun

et al. 2022

Contrast Media & Molecular Imaging

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Objective. To observe the effects of improvement of cervical spondylotic myelopathy with different imaging signals after cortical somatosensory-evoked potentials on the functional recovery of postoperative patients and the effect of surgery. Methods. A total of 60 patients with cervical spondylotic myelopathy who were hospitalized in our hospital from January 2020 to December 2020 were selected and divided into a case group (30 cases) with MRI-indicated changes in intramedullary signals and a control group (30 cases) with MRI-indicated spinal cord changes. Intragroup and intergroup control studies were conducted through general observation indexes, neurological evaluation indexes, imaging, and evoked potential observation indexes. Somatosensory-evoked potentials were performed before operation, 1 week after operation, and 24 weeks after operation, and the JOA score of each patient was obtained before operation, 1 week after operation, and 24 weeks after operation. Results. The JOA score of 1 week after operation of the case group is (16.25 ± 1.54) and the control group is (11.89 ± 1.63), and there is a statistically significant difference (P < 0.05). The JOA score of the case group 24 weeks after operation is (25.27 ± 1.03) and the control group is (13.28 ± 1.03), and the difference is statistically significant (P < 0.05). The improvement rate of 1 week after operation and 24 weeks after operation was statistically significant between the two groups (P < 0.05). The case group improvement rate is (70.5 ± 8.72)% and the control group is (40.5 ± 9.81)%, and the difference is statistically significant between the two groups (P < 0.05). Conclusion. The preoperative intramedullary signal changes can be used as an effective index for patients with cervical spondylotic myelopathy to use somatosensory-evoked potentials to assess the prognosis of patients after surgery.

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Section: Discussionmentioning

confidence: 99%

[Retracted] Clinical Application of Evoked Potentials in the Operation of Cervical Spondylotic Myelopathy with Different Imaging

Ding

Zong

Zong-jun

et al. 2022

Contrast Media & Molecular Imaging

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“…Through comparison and analysis of the biomechanical changes of the four minimally invasive surgeries models, we hope to provide some evidences for surgeons to support their selection of appropriate surgical plans. From previous research ( Ren et al, 2019 ; Yuchi et al, 2019 ; Chen et al, 2020 ; Ke et al, 2020 ), the assessment of biomechanics includes the following parameters: ROM, IDP, AFP, and FJs CPRESS. However, the biomechanical characteristics of UJs, which are a unique structure of the cervical spine, are not completely clear after minimally invasive surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…The vertebral body was simulated by four-node tetrahedral elements, and the rest of the material was simulated by eight-node hexahedral elements. The detailed material properties ( Lee et al, 2011 ; Cai et al, 2020a ; Guan et al, 2020 ; Hua et al, 2020 ; Ke et al, 2020 ; Wang et al, 2020 ; Sang et al, 2021 ; Wo et al, 2021 ) of all parts are presented in Table 1 .…”

Section: Methodsmentioning

confidence: 99%

Comparative Analysis of the Biomechanical Characteristics After Different Minimally Invasive Surgeries for Cervical Spondylopathy: A Finite Element Analysis

Zhang

et al. 2021

Front. Bioeng. Biotechnol.

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Minimally invasive surgeries, including posterior endoscopic cervical foraminotomy (PECF), microsurgical anterior cervical foraminotomy (MACF), anterior transdiscal approach of endoscopic cervical discectomy (ATd-ECD), and anterior transcorporeal approach of endoscopic cervical discectomy (ATc-ECD), have obtained positive results for cervical spondylotic radiculopathy. Nonetheless, there is a lack of comparison among them regarding their biomechanical performance. The purpose of this study is to investigate the biomechanical changes of operated and adjacent segments after minimally invasive surgeries compared to a normal cervical spine. A three-dimensional model of normal cervical vertebrae C3–C7 was established using finite element analysis. Afterwards, four surgical models (PECF, MACF, ATd-ECD, and ATc-ECD) were constructed on the basis of the normal model. Identical load conditions were applied to simulate flexion, extension, lateral bending, and axial rotation of the cervical spine. We calculated the range of motion (ROM), intradiscal pressure (IDP), annulus fibrosus pressure (AFP), uncovertebral joints contact pressure (CPRESS), and facet joints CPRESS under different motions. For all circumstances, ATc-ECD was close to the normal cervical spine model, whereas ATd-ECD significantly increased ROM and joints CPRESS and decreased IDP in the operated segment. PECF increased more the operated segment ROM than did the MACF, but the MACF obtained maximum IDP and AFP. Except for ATc-ECD, the other models increased joints CPRESS of the operated segment. For adjacent segments, ROM, IDP, and joints CPRESS showed a downward trend in all models. All models showed good biomechanical stability. With their combination biomechanics, safety, and conditions of application, PECF and ATc-ECD could be appropriate choices for cervical spondylotic radiculopathy.

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“…Cervical spondylotic radiculopathy (CSR) is often caused by nerve compression due to cervical disc herniation, intervertebral foramen stenosis, and hyperplastic osteophytes 1 , 2 . Its main symptoms include pain in the neck and upper limbs, with or without numbness, and with surgical treatment needed in severe cases 3 .…”

Section: Introductionmentioning

confidence: 99%

Application of Triggered EMG in the Intraoperative Neurophysiological Monitoring of Posterior Percutaneous Endoscopic Cervical Discectomy

Wang

Zhao

Geng

et al. 2021

Orthopaedic Surgery

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Objective: To describe the rationale and application of triggered EMG (T-EMG) in intraoperative neurophysiological monitoring, and to explore the efficacy and safety of posterior percutaneous endoscopic cervical discectomy (PPECD) in the treatment of cervical spondylotic radiculopathy (CSR) under multimodal intraoperative neurophysiological monitoring (IOM).Methods: This study was a retrospective cohort control study. The clinical data of 74 patients with single-segment CSR from June 2015 to August 2018 were analyzed retrospectively, of whom 35 underwent IOM-assisted PPECD with triggered EMG (T-EMG group), while 39 were subjected to IOM-assisted PPECD alone (IOM group). Operation time, hospital stay, and complications were recorded for both groups. The curative effect was evaluated according to the Visual Analog Scale (VAS) of neck and arm pain, Japanese Orthopaedic Association (JOA) score, and modified MacNab scale.Results: Operations were successful and all patients were followed up for at least 24 (average 31.77 AE 9.51) months with no patient lost to follow-up. No significant difference was found in preoperative baseline data between the T-EMG and the IOM group (P > 0.05). Also, no significant difference was found in the operation time between the T-EMG (108.29 AE 11.44 min) and the IOM (110.13 AE 12.70 min) (P > 0.05) group, but the difference in hospital stay (T-EMG: 5.66 AE 0.99 days; IOM: 7.10 AE 1.43 days) was statistically significant (P < 0.05). The VAS for the neck and upper limbs in the two groups at 1 month post-operation (T-EMG: 2.09

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Percutaneous posterior full-endoscopic cervical foraminotomy and discectomy: a finite element analysis and radiological assessment

Cited by 8 publications

References 29 publications

[Retracted] Clinical Application of Evoked Potentials in the Operation of Cervical Spondylotic Myelopathy with Different Imaging

[Retracted] Clinical Application of Evoked Potentials in the Operation of Cervical Spondylotic Myelopathy with Different Imaging

Comparative Analysis of the Biomechanical Characteristics After Different Minimally Invasive Surgeries for Cervical Spondylopathy: A Finite Element Analysis

Application of Triggered EMG in the Intraoperative Neurophysiological Monitoring of Posterior Percutaneous Endoscopic Cervical Discectomy

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