Anterior cervical discectomy and intervertebral fusion using endoscopic procedure / 中华骨科杂志

ABSTRACT

Objective To report the results using endoscopic techniques in ce rvical discectomy and intervertebral fusion. Methods From October 2002 to August 2003, 26 patients underwent cervical discectomy and intervertebral fusion using endoscopic techniques. 16 patients had been followed-up more than 3 months, inc luding 4 females and 12 males. The average age was 53.2 years (range, 23 to 65 y ears). The disorders lasted from 3 to 14 months before surgery. There were 3 cas es of cervical injury associated cervical disc herniation (CDH), 8 of cervical s pondylotic myelopathy (CSM), 2 of solitary ossification of the posterior longitu dinal ligament (OPLL), and 3 of radiculopathy. The mean preoperative ADL of Japa nese Orthopedic Association (JOA) score was 7.2. The working channel was inserte d through a 2 cm long incision, the protruded discs or ossified posterior longit udinal ligaments were excised for complete decompression, then an appropriate in tervertebral PEEK fusion cage was implanted. Results All patients obtained endos copic cervical discectomy and interbody fusion successfully. None of cases was c onverted to open procedures. The surgery lasted an average of 120 min (range, 50 to 150 min), mean blood loss was 110 ml (range, from 40 to 140 ml). There was n o complication during operation and no any stimulating symptoms on laryngopharyn x after surgery. However, postoperative hemorrhage of the incision occurred in 1 case, then an injury of a thyroid vessel was found during immediate exploration . The follow-up period extended from 3 to 8 months (mean, 6.5 months), the aver age preoperative ADL of JOA score was 13.1 while the improvement rate was 60.2%. Conclusion The cervical discectomy and intervertebral fusion through endoscopi c approach is able to reduce the soft tissue injury and the incidence of stimula ting symptoms on laryngopharynx, which makes the surgery more safe. The indicati ons for this procedure include cervical disc herniation, cervical myelopathy, ra diculopathy, and traumatic cervical disc injury on C3,4 to C5,6 segments.