Anterior percutaneous full-endoscopic transcorporeal decompression of the spinal cord via one vertebra with two bony channels for adjacent two-segment cervical spondylotic myelopathy: a technical note.
Anterior approach
Cervical spondylotic myelopathy
Decompression of spinal cord
Full-endoscopic
Transcorporeal
Two bony channels.
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
26 Oct 2023
26 Oct 2023
Historique:
received:
30
07
2023
accepted:
18
10
2023
medline:
30
10
2023
pubmed:
27
10
2023
entrez:
26
10
2023
Statut:
epublish
Résumé
The current treatments for adjacent two-segment cervical spondylotic myelopathy (CSM) include two-segment anterior cervical discectomy and fusion (ACDF) and single-segment anterior cervical corpectomy and fusion (ACCF). Long-term follow-up has demonstrated that both procedures have complications such as reduced cervical mobility, accelerated degeneration of adjacent segments and loosening of internal fixation screws. The purpose of this study is to demonstrate the feasibility, safety, and efficacy of anterior percutaneous full-endoscopic transcorporeal decompression of the spinal cord (APFETDSC) via one vertebra with two bony channels for the treatment of adjacent two-segment CSM and to present our surgical experience. Anterior percutaneous full-endoscopic transcorporeal decompression of the spinal cord (APFETDSC) via one vertebra with two bony channels was performed for 12 patients with adjacent two-segment CSM with follow-up care for at least 12 months. The Visual analog scale (VAS) and the Japanese Orthopedic Association Score (JOA) were recorded, and modified Macnab criteria were used to evaluate the treatment excellence rate. Radiological examinations, including X-ray, computed tomography (CT) and magnetic resonance imaging (MRI), were used to evaluate spinal cord decompression, intervertebral stability and healing of the bony channel. All 12 patients completed the operation successfully. No postoperative complications, such as dysphagia, Horner's syndrome, or laryngeal recurrent nerve palsy, were found. The postoperative VAS and JOA scores were significantly improved compared with those before surgery(P < 0.001). According to the modified Macnab criteria, the clinical outcome was excellent in 8 cases, good in 3 cases and fine in 1 case at the final follow-up and the excellent and good rate was 91.7%. Postoperative and follow-up imaging showed significant spinal cord decompression, well-healed bony channels and no cervical instability. This study is the first report of anterior percutaneous full-endoscopic transcorporeal decompression of the spinal cord via one vertebra with two bony channels. This procedure has the advantages of less trauma, faster recovery, fewer complications and no need to implant internal fixators. This is a minimally invasive, feasible and safe surgical procedure for patients with adjacent two-segment CSM.
Sections du résumé
BACKGROUND
BACKGROUND
The current treatments for adjacent two-segment cervical spondylotic myelopathy (CSM) include two-segment anterior cervical discectomy and fusion (ACDF) and single-segment anterior cervical corpectomy and fusion (ACCF). Long-term follow-up has demonstrated that both procedures have complications such as reduced cervical mobility, accelerated degeneration of adjacent segments and loosening of internal fixation screws. The purpose of this study is to demonstrate the feasibility, safety, and efficacy of anterior percutaneous full-endoscopic transcorporeal decompression of the spinal cord (APFETDSC) via one vertebra with two bony channels for the treatment of adjacent two-segment CSM and to present our surgical experience.
METHODS
METHODS
Anterior percutaneous full-endoscopic transcorporeal decompression of the spinal cord (APFETDSC) via one vertebra with two bony channels was performed for 12 patients with adjacent two-segment CSM with follow-up care for at least 12 months. The Visual analog scale (VAS) and the Japanese Orthopedic Association Score (JOA) were recorded, and modified Macnab criteria were used to evaluate the treatment excellence rate. Radiological examinations, including X-ray, computed tomography (CT) and magnetic resonance imaging (MRI), were used to evaluate spinal cord decompression, intervertebral stability and healing of the bony channel.
RESULTS
RESULTS
All 12 patients completed the operation successfully. No postoperative complications, such as dysphagia, Horner's syndrome, or laryngeal recurrent nerve palsy, were found. The postoperative VAS and JOA scores were significantly improved compared with those before surgery(P < 0.001). According to the modified Macnab criteria, the clinical outcome was excellent in 8 cases, good in 3 cases and fine in 1 case at the final follow-up and the excellent and good rate was 91.7%. Postoperative and follow-up imaging showed significant spinal cord decompression, well-healed bony channels and no cervical instability.
CONCLUSIONS
CONCLUSIONS
This study is the first report of anterior percutaneous full-endoscopic transcorporeal decompression of the spinal cord via one vertebra with two bony channels. This procedure has the advantages of less trauma, faster recovery, fewer complications and no need to implant internal fixators. This is a minimally invasive, feasible and safe surgical procedure for patients with adjacent two-segment CSM.
Identifiants
pubmed: 37884962
doi: 10.1186/s12891-023-06978-7
pii: 10.1186/s12891-023-06978-7
pmc: PMC10601313
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
844Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
PLoS One. 2014 Jan 28;9(1):e87191
pubmed: 24489868
World Neurosurg. 2019 Dec;132:47-52
pubmed: 31442650
BMC Musculoskelet Disord. 2019 Jun 10;20(1):280
pubmed: 31182078
Spine (Phila Pa 1976). 2021 Feb 1;46(3):E153-E160
pubmed: 33079908
J Bone Joint Surg Am. 1999 Apr;81(4):519-28
pubmed: 10225797
World Neurosurg. 2018 Oct;118:102-108
pubmed: 30026139
Front Surg. 2022 Nov 02;9:1002744
pubmed: 36406351
Pain Physician. 2021 Sep;24(6):E811-E819
pubmed: 34554701
Photomed Laser Surg. 2014 Dec;32(12):663-8
pubmed: 25393058
Front Bioeng Biotechnol. 2021 Dec 16;9:772853
pubmed: 34976969
J Spinal Disord. 2000 Feb;13(1):16-21
pubmed: 10710143
J Orthop Translat. 2020 Apr 02;23:107-112
pubmed: 32642425
J Orthop Surg Res. 2019 Dec 23;14(1):461
pubmed: 31870395
BMC Musculoskelet Disord. 2022 Nov 30;23(1):1031
pubmed: 36451136
J Clin Med. 2022 Oct 25;11(21):
pubmed: 36362508
Am J Orthop (Belle Mead NJ). 2017 Mar/Apr;46(2):E97-E104
pubmed: 28437502
Neurol Clin. 2013 Feb;31(1):287-305
pubmed: 23186905
World Neurosurg. 2021 Oct;154:109-116
pubmed: 34280535
Eur Spine J. 2015 Apr;24 Suppl 2:209-28
pubmed: 24005994
Clin Neurol Neurosurg. 2020 Jul;194:105919
pubmed: 32446123
Medicine (Baltimore). 2019 Nov;98(45):e17935
pubmed: 31702680
Clin Spine Surg. 2018 Jul;31(6):247-260
pubmed: 29746262
Spine J. 2016 May;16(5):659-66
pubmed: 26850173
World Neurosurg. 2018 Apr;112:e23-e30
pubmed: 29241695
World Neurosurg. 2019 Aug;128:e905-e911
pubmed: 31096026
Med Sci Monit. 2020 Mar 20;26:e921507
pubmed: 32196483
World Neurosurg. 2018 Jun;114:e199-e208
pubmed: 29510277
Clin Spine Surg. 2016 Dec;29(10):408-414
pubmed: 27352369
Ther Clin Risk Manag. 2015 Nov 17;11:1707-18
pubmed: 26604771
Spine (Phila Pa 1976). 2007 Oct 1;32(21):2310-7
pubmed: 17906571
Int J Spine Surg. 2015 Jun 19;9:24
pubmed: 26196031
J Spinal Disord Tech. 2009 Aug;22(6):408-12
pubmed: 19652566