Retrospective Evaluation of Efficiency and Safety of an Anterior Percutaneous Approach for Cervical Discectomy

Abstract

Study DesignRetrospective case series.PurposeThe purpose of the study was to evaluate the efficiency and complication rate of a percutaneous anterior approach to herniated cervical disks with or without concomitant foraminal stenosis and/or spondylosis.Overview of LiteratureRecent publications reflect that minimally invasive procedures gain in importance in patients and spine surgeons as they are generally associated with less tissue damage and shorter recovery times. However, for anterior percutaneous cervical discectomy, very little data is available for relevant patient populations.MethodsCharts from patients with herniated cervical disc confirmed by magnetic resonance imaging, mainly radicular symptoms and irresponsive to conservative treatment who underwent anterior percutaneous discectomy were evaluated retrospectively. All patients were asked to return questionnaires that included visual analogue scores (VAS), MacNab score as well as subjective satisfaction data 2 years after surgery.ResultsNinety-five patients were included. There were no neurological or vascular complications; only one patient suffered from transient hoarseness. During the two years after surgery, 9 patients underwent reoperation. 90.5% of the patients returned the questionnaire at 2 years' follow-up. 87.7% of them reported excellent or good outcome, 11.1% rated results as fair and 1.2% as unsatisfactory. On average, arm and neck pain improved significantly by 6.1 points and 5.8 points respectively on a ten point VAS. 94.5% stated that they would choose the same procedure again.ConclusionsThis procedure has proved a safe and sufficient option for symptomatic cervical disk herniations with or without concomitant spondylosis and/or foraminal stenosis.

A New Progression Towards a Safer Anterior Percutaneous Endoscopic Cervical Discectomy: A Technical Report

“…Nevertheless, PECD carries the risk of major complications as well. There are only few studies on safety measures and complications associated with PECD [15,17].…”

Anterior Percutaneous Cervical Discectomy. Two-Year Follow-Up of a Blunt Technique Procedure

“…[13][14][15]18 For VAS, Sim 18 reported an improvement from 9.3 to 3.4 at the six-month follow-up, and Schubert showed an improvement from 8.3 to 2.5 in a two-year follow-up. 19 Likewise, the use of laser -an analogous technology to the RF used in this study -showed satisfaction rates of around 50% 20 and 90%. 7 These results showing improvement are comparable to the effectiveness rate obtained in this report, even with the technique modification, which suggests that varying the technique would not alter the patients' satisfactory results.…”

“…Finally, Schubert and Merk presented one case of hoarseness in 95 patients. 19 Regarding other techniques of cervical pain treatment, which use the anterior percutaneous approach instead, we must emphasize the major complications reported by Tzaan,17 who showed lesion of the carotid artery in one out of 107 (1%) patients submitted to endoscopic discectomy.…”

Efficacy of a Topical Gelatin-Thrombin Matrix Sealant in Reducing Postoperative Drainage Following Anterior Cervical Discectomy and Fusion

“…One of the most catastrophic complications of anterior cervical discectomy and fusion (ACDF) is postoperative hemorrhage, which may result in dyspnea, respiratory arrest, and death [ 1 2 3 4 5 6 ]. Surgeons need to be alert for this complication and try their best to prevent it [ 7 8 9 10 11 ]. One of the various methods to minimize postoperative hemorrhage is the local application of a hemostatic agent.…”