A retrospective of patients with symptomatic contained cervical
disc herniated were operated on with
PCN and PCD from June 2003 to July 2005. Two-hundred and four patients initially fulfilled the study criteria, and 28 patients were lost in follow-up. The patients were categorized into different groups depending on the procedure by
PCN (81 cases) or PCD (95 cases).
RESULTS: The clinical outcomes,
pain reduction, and segment stability were recorded during this study.
Puncture of the needle into the disc space was accurately performed under C-arm fluoroscopy guidance in all cases and no intraoperative deaths were reported in our study. At the end, 176 cases had follow-up and 28 cases were lost, and the follow-up rate was 88.0% (81/92) in the
PCN group and 84.8% (95/112) in the PCD group. The follow-up time ranged from 16 to 48 months (average 29 months), and on an average of 28.86 ± 4.52 months on
PCN and 8.42 ± 3.21 months on PCD (t = -0.24, P = 0.81, >0.05). The operation time averages of
PCN and PCD are 4.67 ± 1.16 and 11.95 ± 1.80, respectively (P < 0.01). The
pain index improved from 7.12 ± 1.13 to 2.74 ± 0.89 (t = 27.03, P = 0.0000, <0.001) in
PCN patients and from 7.18 ± 1.09 to 2.71 ± 0.91 (t = 29.57, P = 0.0000, <0.001) in PCD patients. Clinical results of
PCN were excellent in 31 cases, good 32 cases, fair 13 cases, and poor 5 cases; for PCD, the results were 33, 42, 12, and 7 cases, respectively, and 1 in
discitis. Good and excellent was 78.4% (77.8% in
PCN and 79.5% in PCD, P > 0.05). There was one case of
PCN that had the partial Perc-D SpineWand broken in the disc space, cannot be moved by the percutaneous cervical
discectomy, and remained there itself. One of the cases had
discitis in this study after PCD. Patient presented with
neck pain and associated radicular
pain and
numbness in the left upper-limb after 8 days of PCD. There were no instable cases after procedures of
PCN and PCD. There were no significant difference in stability of preoperatively and postoperatively between
PCN and PCD (P > 0.05).
CONCLUSIONS:
PCN and PCD treatments of contained cervical
disc herniation show good outcomes and there was no difference in the stability of cervical spine.
PCN and PCD are safe, minimally invasive, and no differences were observed between the methods in clinical outcome.