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, 刘永强, 范金鹏, 等. 颈椎病前路减压融合术疗效分析. 中国骨与关节损伤杂志, 2007, 22(6): 447-449.
4.	刘先银, 莫新发, 何仲佳, 等. 颈椎前路椎体次全切除结合植骨内固定术治疗脊髓型颈椎病. 中国骨与关节损伤杂志, 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.	杨贺军, 简磊, 唐骞, 等. 开放入路(空气/水介质)内镜辅助下颈椎前路间盘切除减压融合术对脊髓型颈椎病的早期疗效及安全性. 中华医学杂志, 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, 郭涛. 术前颈椎 MRI 对成人无骨折脱位型颈脊髓损伤术后预后的分析. 中华全科医学, 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. 显微镜辅助经前路颈椎间盘切除融合术治疗颈椎病 37 例. 中华显微外科杂志, 2019, 42(3): 241-245.
11.	郭玮, 戴驭虎, 彭新生. 显微镜下前路手术治疗颈椎后纵韧带骨化症的经验. 中华显微外科杂志, 2021, 44(5): 572-573.
12.	杨新华, 刘鹏, 张良, 等. 显微镜辅助下经颈椎前路椎间盘切除融合术治疗脊髓型颈椎病的疗效分析. 中华解剖与临床杂志, 2020, 25(5): 560-564.
13.	鲍小明, 任坤, 张小平, 等. 显微镜与直视下颈椎前路椎间盘切除融合术比较. 中国矫形外科杂志, 2023, 31(11): 974-979.
14.	陈昆, 陈培基, 周章南, 等. 显微镜辅助颈前路减压术对脊髓型颈椎病的治疗效果. 贵州医科大学学报, 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.	刘雅普, 高利峰, 徐永辉, 等. 经皮经椎间孔入路内镜下椎间盘切除术治疗腰椎间盘突出症术中并发类脊髓高压症的临床研究. 中国脊柱脊髓杂志, 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.	吴信波, 范国鑫, 顾昕, 等. 显微镜辅助下行颈前路椎间盘切除植骨融合术(ACDF)治疗神经根型颈椎病的疗效分析. 中国矫形外科杂志, 2016, 24(19): 1740-1744.
20.	郭强, 张宏其. 脊柱围手术期隐性出血的研究进展. 脊柱外科杂志, 2015, 13(3): 186-188.
21.	郭涛, 党大胜, 宋洪涛, 等. 医用无菌骨蜡的生物相容性和骨创面止血的疗效评价. 中国药房, 2005, 16(1): 24-26.
22.	李志辉, 张亦工, 王彦伟, 等. 颈椎前路手术中出血原因分析及防治对策. 中国骨与关节损伤杂志, 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, 刘永强, 范金鹏, 等. 颈椎病前路减压融合术疗效分析. 中国骨与关节损伤杂志, 2007, 22(6): 447-449.
4. 刘先银, 莫新发, 何仲佳, 等. 颈椎前路椎体次全切除结合植骨内固定术治疗脊髓型颈椎病. 中国骨与关节损伤杂志, 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. 杨贺军, 简磊, 唐骞, 等. 开放入路(空气/水介质)内镜辅助下颈椎前路间盘切除减压融合术对脊髓型颈椎病的早期疗效及安全性. 中华医学杂志, 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, 郭涛. 术前颈椎 MRI 对成人无骨折脱位型颈脊髓损伤术后预后的分析. 中华全科医学, 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. 显微镜辅助经前路颈椎间盘切除融合术治疗颈椎病 37 例. 中华显微外科杂志, 2019, 42(3): 241-245.
11. 郭玮, 戴驭虎, 彭新生. 显微镜下前路手术治疗颈椎后纵韧带骨化症的经验. 中华显微外科杂志, 2021, 44(5): 572-573.
12. 杨新华, 刘鹏, 张良, 等. 显微镜辅助下经颈椎前路椎间盘切除融合术治疗脊髓型颈椎病的疗效分析. 中华解剖与临床杂志, 2020, 25(5): 560-564.
13. 鲍小明, 任坤, 张小平, 等. 显微镜与直视下颈椎前路椎间盘切除融合术比较. 中国矫形外科杂志, 2023, 31(11): 974-979.
14. 陈昆, 陈培基, 周章南, 等. 显微镜辅助颈前路减压术对脊髓型颈椎病的治疗效果. 贵州医科大学学报, 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. 刘雅普, 高利峰, 徐永辉, 等. 经皮经椎间孔入路内镜下椎间盘切除术治疗腰椎间盘突出症术中并发类脊髓高压症的临床研究. 中国脊柱脊髓杂志, 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. 吴信波, 范国鑫, 顾昕, 等. 显微镜辅助下行颈前路椎间盘切除植骨融合术(ACDF)治疗神经根型颈椎病的疗效分析. 中国矫形外科杂志, 2016, 24(19): 1740-1744.
20. 郭强, 张宏其. 脊柱围手术期隐性出血的研究进展. 脊柱外科杂志, 2015, 13(3): 186-188.
21. 郭涛, 党大胜, 宋洪涛, 等. 医用无菌骨蜡的生物相容性和骨创面止血的疗效评价. 中国药房, 2005, 16(1): 24-26.
22. 李志辉, 张亦工, 王彦伟, 等. 颈椎前路手术中出血原因分析及防治对策. 中国骨与关节损伤杂志, 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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