Clinical efficacy of endoscopy-assisted anterior cervical discectomy and fusion for cervical spondylosis_West China Medical Journal

Authors：

GONG Shuangquan ,  CUI Liqiang , XIE Shiming , YE Yu , LIU Hongjun , WANG Chenglong , LIU Dengshang

Department of Minimally Invasive Spine, Mianyang Orthopedic Hospital, Mianyang, Sichuan 621000, P. R. China;

Corresponding?author：

CUI Liqiang, Email: papaya1999@163.com

Keywords：

Spinal endoscopy; cervical spondylosis; anterior cervical discectomy and fusion

DOI：

10.7507/1002-0179.202408239

Video：

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Objective To investigate the clinical efficacy of endoscopy-assisted anterior cervical discectomy and fusion for cervical spondylosis. Methods The clinical data of patients treated with water medium endoscopy-assisted anterior cervical discectomy and fusion for cervical spondylosis at Mianyang Orthopedic Hospital between September 2021 and September 2023 were retrospectively collected. The surgical efficacy and nerve injury recovery were evaluated based on the Neck Disabilitv Index (NDI), Japanese Orthopaedic Association (JOA) score, improvement rate of JOA score, Cobb angle and height changes of the affected intervertebral space before surgery and at the last follow-up, as well as the occurrence of surgical complications. Results A total of 29 patients were included, including 18 males and 11 females. The average age was (52.34±8.96) years, and the average duration of illness was (17.31±6.60) months. The average follow-up time was (11.69±3.41) months. At the last follow-up, the patients’ NDI (3.55±3.09 vs. 17.28±5.51), Cobb angle [(15.25±4.83) vs. (?1.34±7.50)°], intervertebral height [(8.04±0.82) vs. (4.67±0.95) mm], and JOA score (15.90±1.11 vs. 11.17±1.65) improved compared to preoperative levels (P<0.05). The JOA score improvement rate assessment showed that 16 cases were excellent, 11 cases were fine, 2 cases were moderate, and the excellent and fine rate was 93.10%. All patients did not experience serious complications after surgery. Conclusion Water medium endoscopy-assisted anterior cervical discectomy and fusion for cervical spondylosis has good clinical efficacy and safety.

Citation： GONG Shuangquan, CUI Liqiang, XIE Shiming, YE Yu, LIU Hongjun, WANG Chenglong, LIU Dengshang. Clinical efficacy of endoscopy-assisted anterior cervical discectomy and fusion for cervical spondylosis. West China Medical Journal, 2024, 39(10): 1526-1530. doi: 10.7507/1002-0179.202408239 Copy

1.	Tabaraee E, Ahn J, Bohl DD, et al. The impact of worker’s compensation claims on outcomes and costs following an anterior cervical discectomy and fusion. Spine (Phila Pa 1976), 2015, 40(12): 948-953.
2.	Jiang SD, Jiang LS, Dai LY. Anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion for multilevel cervical spondylosis: a systematic review. Arch Orthop Trauma Surg, 2012, 132(2): 155-161.
3.	申勇, 劉永強, 范金鵬, 等. 頸椎病前路減壓融合術療效分析. 中國骨與關節損傷雜志, 2007, 22(6): 447-449.
4.	劉先銀, 莫新發, 何仲佳, 等. 頸椎前路椎體次全切除結合植骨內固定術治療脊髓型頸椎病. 中國骨與關節損傷雜志, 2005, 20(6): 367-369.
5.	Chang SW, Kakarla UK, Maughan PH, et al. Four-level anterior cervical discectomy and fusion with plate fixation: radiographic and clinical results. Neurosurgery, 2010, 66(4): 639-646.
6.	楊賀軍, 簡磊, 唐騫, 等. 開放入路(空氣/水介質)內鏡輔助下頸椎前路間盤切除減壓融合術對脊髓型頸椎病的早期療效及安全性. 中華醫學雜志, 2023, 103(35): 2795-2800.
7.	Vernon H. The Neck Disability Index: state-of-the-art, 1991-2008. J Manipulative Physiol Ther, 2008, 31(7): 491-502.
8.	李家冉, 郭濤. 術前頸椎 MRI 對成人無骨折脫位型頸脊髓損傷術后預后的分析. 中華全科醫學, 2023, 21(5): 753-756, 760.
9.	Yadav YR, Parihar V, Ratre S, et al. Endoscopic decompression of cervical spondylotic myelopathy using posterior approach. Neurol India, 2014, 62(6): 640-645.
10.	王晶, 杜江, 梁耀中, 等. 顯微鏡輔助經前路頸椎間盤切除融合術治療頸椎病 37 例. 中華顯微外科雜志, 2019, 42(3): 241-245.
11.	郭瑋, 戴馭虎, 彭新生. 顯微鏡下前路手術治療頸椎后縱韌帶骨化癥的經驗. 中華顯微外科雜志, 2021, 44(5): 572-573.
12.	楊新華, 劉鵬, 張良, 等. 顯微鏡輔助下經頸椎前路椎間盤切除融合術治療脊髓型頸椎病的療效分析. 中華解剖與臨床雜志, 2020, 25(5): 560-564.
13.	鮑小明, 任坤, 張小平, 等. 顯微鏡與直視下頸椎前路椎間盤切除融合術比較. 中國矯形外科雜志, 2023, 31(11): 974-979.
14.	陳昆, 陳培基, 周章南, 等. 顯微鏡輔助頸前路減壓術對脊髓型頸椎病的治療效果. 貴州醫科大學學報, 2021, 46(10): 1231-1235.
15.	Bruneau M, Cornelius JF, George B. Multilevel oblique corpectomies: surgical indications and technique. Neurosurgery, 2007, 61(Suppl 3): 106-112.
16.	劉雅普, 高利峰, 徐永輝, 等. 經皮經椎間孔入路內鏡下椎間盤切除術治療腰椎間盤突出癥術中并發類脊髓高壓癥的臨床研究. 中國脊柱脊髓雜志, 2019, 29(4): 382-384.
17.	Kim J, Heo DH, Lee DC, et al. Biportal endoscopic unilateral laminotomy with bilateral decompression for the treatment of cervical spondylotic myelopathy. Acta Neurochir (Wien), 2021, 163(9): 2537-2543.
18.	Yao N, Wang C, Wang W, et al. Full-endoscopic technique for anterior cervical discectomy and interbody fusion: 5-year follow-up results of 67 cases. Eur Spine J, 2011, 20(6): 899-904.
19.	吳信波, 范國鑫, 顧昕, 等. 顯微鏡輔助下行頸前路椎間盤切除植骨融合術(ACDF)治療神經根型頸椎病的療效分析. 中國矯形外科雜志, 2016, 24(19): 1740-1744.
20.	郭強, 張宏其. 脊柱圍手術期隱性出血的研究進展. 脊柱外科雜志, 2015, 13(3): 186-188.
21.	郭濤, 黨大勝, 宋洪濤, 等. 醫用無菌骨蠟的生物相容性和骨創面止血的療效評價. 中國藥房, 2005, 16(1): 24-26.
22.	李志輝, 張亦工, 王彥偉, 等. 頸椎前路手術中出血原因分析及防治對策. 中國骨與關節損傷雜志, 2013, 28(11): 1044-1045.
23.	Zhang Y, Feng B, Ning H, et al. One-hole split endoscope technique for migrated lumbar disc herniation: a single-centre, retrospective study of a novel technique. J Orthop Surg Res, 2023, 18(1): 483.

1. Tabaraee E, Ahn J, Bohl DD, et al. The impact of worker’s compensation claims on outcomes and costs following an anterior cervical discectomy and fusion. Spine (Phila Pa 1976), 2015, 40(12): 948-953.
2. Jiang SD, Jiang LS, Dai LY. Anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion for multilevel cervical spondylosis: a systematic review. Arch Orthop Trauma Surg, 2012, 132(2): 155-161.
3. 申勇, 劉永強, 范金鵬, 等. 頸椎病前路減壓融合術療效分析. 中國骨與關節損傷雜志, 2007, 22(6): 447-449.
4. 劉先銀, 莫新發, 何仲佳, 等. 頸椎前路椎體次全切除結合植骨內固定術治療脊髓型頸椎病. 中國骨與關節損傷雜志, 2005, 20(6): 367-369.
5. Chang SW, Kakarla UK, Maughan PH, et al. Four-level anterior cervical discectomy and fusion with plate fixation: radiographic and clinical results. Neurosurgery, 2010, 66(4): 639-646.
6. 楊賀軍, 簡磊, 唐騫, 等. 開放入路(空氣/水介質)內鏡輔助下頸椎前路間盤切除減壓融合術對脊髓型頸椎病的早期療效及安全性. 中華醫學雜志, 2023, 103(35): 2795-2800.
7. Vernon H. The Neck Disability Index: state-of-the-art, 1991-2008. J Manipulative Physiol Ther, 2008, 31(7): 491-502.
8. 李家冉, 郭濤. 術前頸椎 MRI 對成人無骨折脫位型頸脊髓損傷術后預后的分析. 中華全科醫學, 2023, 21(5): 753-756, 760.
9. Yadav YR, Parihar V, Ratre S, et al. Endoscopic decompression of cervical spondylotic myelopathy using posterior approach. Neurol India, 2014, 62(6): 640-645.
10. 王晶, 杜江, 梁耀中, 等. 顯微鏡輔助經前路頸椎間盤切除融合術治療頸椎病 37 例. 中華顯微外科雜志, 2019, 42(3): 241-245.
11. 郭瑋, 戴馭虎, 彭新生. 顯微鏡下前路手術治療頸椎后縱韌帶骨化癥的經驗. 中華顯微外科雜志, 2021, 44(5): 572-573.
12. 楊新華, 劉鵬, 張良, 等. 顯微鏡輔助下經頸椎前路椎間盤切除融合術治療脊髓型頸椎病的療效分析. 中華解剖與臨床雜志, 2020, 25(5): 560-564.
13. 鮑小明, 任坤, 張小平, 等. 顯微鏡與直視下頸椎前路椎間盤切除融合術比較. 中國矯形外科雜志, 2023, 31(11): 974-979.
14. 陳昆, 陳培基, 周章南, 等. 顯微鏡輔助頸前路減壓術對脊髓型頸椎病的治療效果. 貴州醫科大學學報, 2021, 46(10): 1231-1235.
15. Bruneau M, Cornelius JF, George B. Multilevel oblique corpectomies: surgical indications and technique. Neurosurgery, 2007, 61(Suppl 3): 106-112.
16. 劉雅普, 高利峰, 徐永輝, 等. 經皮經椎間孔入路內鏡下椎間盤切除術治療腰椎間盤突出癥術中并發類脊髓高壓癥的臨床研究. 中國脊柱脊髓雜志, 2019, 29(4): 382-384.
17. Kim J, Heo DH, Lee DC, et al. Biportal endoscopic unilateral laminotomy with bilateral decompression for the treatment of cervical spondylotic myelopathy. Acta Neurochir (Wien), 2021, 163(9): 2537-2543.
18. Yao N, Wang C, Wang W, et al. Full-endoscopic technique for anterior cervical discectomy and interbody fusion: 5-year follow-up results of 67 cases. Eur Spine J, 2011, 20(6): 899-904.
19. 吳信波, 范國鑫, 顧昕, 等. 顯微鏡輔助下行頸前路椎間盤切除植骨融合術(ACDF)治療神經根型頸椎病的療效分析. 中國矯形外科雜志, 2016, 24(19): 1740-1744.
20. 郭強, 張宏其. 脊柱圍手術期隱性出血的研究進展. 脊柱外科雜志, 2015, 13(3): 186-188.
21. 郭濤, 黨大勝, 宋洪濤, 等. 醫用無菌骨蠟的生物相容性和骨創面止血的療效評價. 中國藥房, 2005, 16(1): 24-26.
22. 李志輝, 張亦工, 王彥偉, 等. 頸椎前路手術中出血原因分析及防治對策. 中國骨與關節損傷雜志, 2013, 28(11): 1044-1045.
23. Zhang Y, Feng B, Ning H, et al. One-hole split endoscope technique for migrated lumbar disc herniation: a single-centre, retrospective study of a novel technique. J Orthop Surg Res, 2023, 18(1): 483.

West China Medical Journal

Clinical efficacy of endoscopy-assisted anterior cervical discectomy and fusion for cervical spondylosis

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