Endoscopic anterior approach for cervical disc disease (disc preserving surgery).

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Endoscopic anterior approach for cervical disc disease (disc preserving surgery).

World Neurosurg. 2018 Apr 24;:

Authors: Parihar VS, Yadav N, Ratre S, Amitesh Dubey M, Yadav YR

Abstract
BACKGROUND: Anterior endoscopic techniques in cervical disc were found to be effective and safe. We report our experience of 210 patients of endoscopic disc removal by anterior approach which is largest series for management of cervical myelopathy.
METHODS: Visual analogue scale (VAS) and Nurick grading system was used to assess severity of neck and arm pain and functional outcomes respectively. Myelopathy (with or without unilateral or bilateral radiculopathy), or the unilateral radiculopathy having either soft or hard disc prolapsed were included. Patients with 3 or more-disc levels, unstable spine, infections or trauma, significant posterior compression, congenital canal stenosis, disc extending more than half vertebral body height, and prior surgery at the same level were excluded.
RESULTS: A retrospective study of 187 single and 23 double level disc was performed. There were 119, 58, 49, 6, and 1 patients at C5-6, C6-7, C4-5, C3-4 and C2-3 levels, respectively. Preoperative mean VAS scores for arm and neck pain were 6.7 and 3.2 respectively, which improved to 1.7 and 1.1 respectively at 3-month after surgery. The average preoperative Nurick grade improved from 2.64 to 0.81 at 6 months post-operatively. Follow-up ranged from 6 to 54 months.
CONCLUSION: Endoscopic anterior discectomy (disc preserving surgery) was effective and safe alternative in cervical disc disease. Although there was reduction in disc height, clinical outcome was good at an average 29 months follow up. Long term follow up is required to assess any progressive disc degeneration and clinical results.

PMID: 29702310 [PubMed - as supplied by publisher]

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