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      Posterior Percutaneous Endoscopic Cervical Discectomy for Single-Segment Cervical Spondylotic Radiculopathy: A Retrospective Study with Minimum 3-Year Follow-Up

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          Abstract

          Background

          Posterior percutaneous endoscopic cervical discectomy (P-PECD) has been increasingly used for cervical spondylotic radiculopathy (CSR), while few studies have reported on its medium-long-term outcomes. This study aims to investigate the medium-long-term efficacy and imaging findings of P-PECD in the treatment of single-segment CSR.

          Methods

          The data of 51 patients with single-segment CSR treated with P-PECD were retrospectively analyzed. Efficacy was evaluated using visual analog scale (VAS) scores of neck and arm, Japanese Orthopaedic Association (JOA) score, neck disability index (NDI), and modified Macnab criteria. Radiologic parameters were measured before and after the operation, including cervical Cobb angle, range of motion (ROM), intervertebral space height, as well as horizontal and angular displacement at the operative level.

          Results

          The VAS scores of neck and arm, JOA score, and NDI were significantly improved postoperatively compared with those before the operation, and the differences were statistically significant ( P <0.05). Based on the modified Macnab criteria at the final follow-up, 94.12% showed excellent to good outcomes. Postoperatively, the cervical Cobb angle was 10.63 ± 1.79 °, ROM was 6.33 ± 1.11 °, the intervertebral space height was 4.63 ± 0.85 mm, horizontal and angular displacement at the operative level were 0.88 ± 0.68 mm and 4.25 ± 1.04 °, respectively, and there were no significantly changed at the final follow-up.

          Conclusion

          P-PECD for single-segment CSR has the advantages of less trauma, less bleeding, a low complication rate, faster postoperative recovery, and less impact on cervical mobility and stability, which has excellent medium-long-term efficacy.

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          Most cited references34

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          A new full-endoscopic technique for cervical posterior foraminotomy in the treatment of lateral disc herniations using 6.9-mm endoscopes: prospective 2-year results of 87 patients.

          Anterior cervical decompression and fusion (ACDF) is the standard procedure for operation of cervical disc herniations with radicular arm pain. Mobility-preserving posterior foraminotomy is the most common alternative in the case of a lateral localization of the pathology. Despite good clinical results, problems may arise due to traumatization of the access. Endoscopic techniques are considered standard in many areas, since they may offer advantages in surgical technique and rehabilitation. These days, all disc herniations of the lumbar spine can be operated in a full-endoscopic technique. The objective of this prospective study was to examine the technical possibilities of full-endoscopic posterior foraminotomy in the treatment of cervical lateral disc herniations. 87 patients were followed for 2 years. The results show that 87.4% no longer have arm pain and 9.2% have only occasional pain. The decompression results were equal to those of conventional procedures. The operation-related traumatization was reduced. The recurrence rate was 3.4%. No serious surgical complications occurred. The recorded results show that the full-endoscopic posterior foraminotomy is a sufficient and safe supplement and alternative to conventional procedures when the indication criteria are fulfilled. At the same time, it offers the advantages of a minimally invasive intervention.
            • Record: found
            • Abstract: not found
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            Is Open Access

            Spinal endoscopy: evidence, techniques, global trends, and future projections

              • Record: found
              • Abstract: found
              • Article: not found

              Percutaneous endoscopic cervical discectomy: a technical review

              The treatment of cervical disc herniations has evolved in the last 2 decades. While the anterior cervical discectomy and fusion continues being the gold standard for the treatment of radicular pain triggered by cervical disc herniation, other surgical approaches have been developed. Percutaneous endoscopic cervical discectomy has demonstrated the ability to decompress the exiting nerve root and dural sac correctly and encouraging clinical outcomes has been reported in the literature. One of the most important advantages offered by the endoscopic technique is the capability to resolve the patient’s symptoms without the need for interbody fusion. Also, a specific and selective decompression under continuous visualization with minimal surgery-related trauma can be achieved. There are two percutaneous endoscopic cervical discectomy approaches: anterior and posterior. The decision to perform each other depends on pathology site. However, the endoscopic technique requires previous surgical training, a steep learning curve, and proper patient selection. The development of new hardware such as endoscopes with better optics, lighting systems, and endoscopic surgical tools have allowed using endoscopic techniques in more complex cases. The objective of this review is the technical description of the anterior and posterior percutaneous endoscopic cervical discectomy.

                Author and article information

                Journal
                J Pain Res
                J Pain Res
                jpr
                Journal of Pain Research
                Dove
                1178-7090
                09 June 2025
                2025
                : 18
                : 2879-2888
                Affiliations
                [1 ]Department of Spinal Surgery, Shaoyang Central Hospital , Shaoyang, Hunan, 422000, People’s Republic of China
                [2 ]Department of Orthopaedics, The First Affiliated Hospital of Xinjiang Medical University , Urumqi, Xinjiang, 830054, People’s Republic of China
                [3 ]Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University , Changsha, Hunan, 410008, People’s Republic of China
                Author notes
                Correspondence: Yubin Long, Department of Spinal Surgery, Shaoyang Central Hospital , Shaoyang, Hunan, 422000, People’s Republic of China, Email spineyb07@tmu.edu.cn
                Yong Li, Department of Spinal Surgery, Shaoyang Central Hospital , Shaoyang, Hunan, 422000, People’s Republic of China, Email fasaj2009@163.com
                [*]

                These authors contributed equally to this work

                Author information
                http://orcid.org/0000-0002-8068-2616
                http://orcid.org/0000-0002-3877-2749
                http://orcid.org/0009-0000-8482-0978
                http://orcid.org/0009-0000-9380-5577
                Article
                519127
                10.2147/JPR.S519127
                12165176
                202fc235-25af-45d4-b275-fabb341b6d56
                © 2025 Wang et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v4.0) License ( http://creativecommons.org/licenses/by-nc/4.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 13 February 2025
                : 28 May 2025
                Page count
                Figures: 1, Tables: 3, References: 34, Pages: 10
                Funding
                Funded by: Hunan Provincial Natural Science Foundation, open-funder-registry 10.13039/501100004735;
                This work was supported by the Hunan Provincial Natural Science Foundation of China (2024JJ7474 and 2022JJ50024) and Science and Technology Plan Project Funding Grant of Shaoyang City (2023NS2015).
                Categories
                Original Research

                Anesthesiology & Pain management
                cervical spondylotic radiculopathy,percutaneous endoscopic,discectomy,minimally invasive

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