Clinical and Radiographic Outcomes of Cervical Disc Replacement Versus Posterior Endoscopic Cervical Decompression: A Matched-Pair Comparison Analysis.
Vit Kotheeranurak, Khanathip Jitpakdee, Kai-Uwe Lewandrowski, Guang-Xun Lin, Weerasak Singhatanadgige, Worawat Limthongkul, Wicharn Yingsakmongkol, Jin-Sung Kim, Wongthawat Liawrungrueang
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引用次数: 0
Abstract
Objective: To compare clinical and radiographic outcomes between 2 motion preservation surgeries, cervical disc replacement (CDR) and posterior endoscopic cervical decompression (PECD), for unilateral cervical radiculopathy.
Methods: Between February 2018 and December 2020, 60 patients with unilateral cervical radiculopathy who underwent either CDR or PECD were retrospectively recruited as matched pairs. Clinical outcomes included visual analogue scale (VAS) scores for neck and arm pain, Neck Disability Index (NDI), and satisfaction rates. The radiographic outcome was index level motion. Intraoperative data, complications, and hospital stay were collected. Preoperative and postoperative outcomes were compared.
Results: Patients undergoing CDR or PECD were included, with 30 cases in each group. Matched pairs were compared in terms of demographic data and preoperative measurements. CDR was associated with shorter operative times, whereas PECD resulted in less intraoperative blood loss. The total complication rate was 5%. NDI and VAS for neck and arm were significantly improved in both groups, with no significant differences between the 2 groups. Satisfaction rates of good and excellent exceeded 87% in both groups. CDR was superior to PECD in the restoration of disc height. Early postoperative follow-up showed no significant difference in terms of index level motion. PECD demonstrated significantly shorter hospital stays and quicker return-to-work times (p<0.05).
Conclusion: PECD achieved equivalent clinical and radiologic outcomes compared with CDR when the certain criteria for surgery were met. Both techniques demonstrated the potential to maintain index level motion. Additionally, PECD resulted in less blood loss, shorter hospital stays, and faster return-to-work times. Conversely, CDR offered shorter operative times and better restoration of disc height.
目的：比较颈椎间盘置换术（CDR）和后路内窥镜颈椎减压术（PECD）这两种运动保留手术治疗单侧颈椎根病变的临床和影像学结果：在2018年2月至2020年12月期间，回顾性招募了60名接受CDR或PECD治疗的单侧颈椎病患者作为配对。临床结果包括颈部和手臂疼痛的视觉模拟量表（VAS）评分、颈部残疾指数（NDI）和满意率。放射学结果为指数水平运动。收集了术中数据、并发症和住院时间。对术前和术后结果进行比较：结果：纳入了接受CDR或PECD的患者，每组30例。比较了配对患者的人口统计学数据和术前测量结果。CDR缩短了手术时间，而PECD减少了术中失血。总并发症发生率为 5%。两组患者颈部和手臂的 NDI 和 VAS 均有明显改善，两组之间无显著差异。两组的良好和优秀满意率均超过 87%。在恢复椎间盘高度方面，CDR优于PECD。术后早期随访显示，两组在指数水平运动方面无明显差异。PECD的住院时间明显更短，重返工作岗位的时间更快（p结论：在符合特定手术标准的情况下，PECD与CDR相比取得了同等的临床和放射学效果。两种技术都显示出维持指数水平运动的潜力。此外，PECD 的失血量更少、住院时间更短、重返工作岗位的时间更快。相反，CDR的手术时间更短，椎间盘高度恢复得更好。
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