Clinical and Radiological Outcomes of a Comparative Study of Anterior Cervical Decompression and Fusion with Partial Pediculotomy, Partial Vertebrotomy (PPPV) Posterior Endoscopic Cervical Decompression (PECD) for Cervical Foraminal Pathology
<i>Background and Objectives</i>: The purpose was to compaSre medium-term clinical and radiological outcomes of Partial Pediculotomy, Partial Vertebrotomy (PPPV) Posterior Endoscopic Cervical Decompression (PECD) surgery versus Anterior Cervical Discectomy and Fusion (ACDF) for patients...
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MDPI AG
2023-06-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/7/1222 |
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| author | Hyeun Sung Kim Pang Hung Wu Brian Zhao Jie Chin Il Tae Jang |
| author_facet | Hyeun Sung Kim Pang Hung Wu Brian Zhao Jie Chin Il Tae Jang |
| author_sort | Hyeun Sung Kim |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: The purpose was to compaSre medium-term clinical and radiological outcomes of Partial Pediculotomy, Partial Vertebrotomy (PPPV) Posterior Endoscopic Cervical Decompression (PECD) surgery versus Anterior Cervical Discectomy and Fusion (ACDF) for patients with cervical disc herniations and foraminal pathologies. <i>Materials and Methods</i>: A prospective registry of patients who had undergone either PPPV PECD surgery or ACDF surgery for cervical disc herniation or foraminal pathologies under a single fellowship-trained spine surgeon was performed. The baseline characteristics and operative details including complications were recorded for all included patients. The clinical outcomes evaluated include VAS, MJOA, motor score, and NDI and MacNab’s score. The radiological parameters in neutral-measured facet length, facet area, disc height, C2–C7 angle, neck tilt angle, T1 slope and thoracic inlet angle were also evaluated. <i>Results</i>: A total of 55 patients (29 PPPV PECD, 26 ACDF) were included, with mean follow-up periods of 21.9 and 32.3 months, respectively. Each cohort was noted to have a single case of surgical complication. Statistically significant changes of facet area (49.05 ± 14.50%) and facet length (52.71 ± 15.11%) were noted in the PPPV PECD group. At neutral alignment of the neck on a lateral X-ray, compared to ACDF, PPPV PECD had a statistically significant change in neck tilt angle (−11.68 ± 17.35°) and T1 slope angle (−11.69 ± 19.58°). Whilst both PPPV PECD and ACDF had significant improvements in VAS, MJOA and NDI postoperatively, PPPV PECD was found to be superior across all above scores at various follow-up timepoints compared to its ACDF counterparts. <i>Conclusions</i>: PPPV PECD surgery achieved a satisfactory radiological correction of neck alignment and significantly improved clinical outcomes at medium-term follow-up for our cohort of patients, highlighting its feasibility in treating patients with cervical disc herniations and foraminal pathologies. |
| first_indexed | 2024-03-11T00:50:57Z |
| format | Article |
| id | doaj.art-81806b0316714b4c9300e582842759ed |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-11T00:50:57Z |
| publishDate | 2023-06-01 |
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| spelling | doaj.art-81806b0316714b4c9300e582842759ed2023-11-18T20:23:33ZengMDPI AGMedicina1010-660X1648-91442023-06-01597122210.3390/medicina59071222Clinical and Radiological Outcomes of a Comparative Study of Anterior Cervical Decompression and Fusion with Partial Pediculotomy, Partial Vertebrotomy (PPPV) Posterior Endoscopic Cervical Decompression (PECD) for Cervical Foraminal PathologyHyeun Sung Kim0Pang Hung Wu1Brian Zhao Jie Chin2Il Tae Jang3Harrison Spinartus Hospital, Chungdam, Seoul 06084, Republic of KoreaAchieve Spine and Orthopaedic Centre, Mount Elizabeth Hospital, Singapore 228510, SingaporeOrthopaedic Surgery, Jurong Health Campus, National University Health System, 1 Jurong East Street 21, Singapore 609606, SingaporeSpines Surgery, Nanoori Gangnam Hospital, Seoul 06048, Republic of Korea<i>Background and Objectives</i>: The purpose was to compaSre medium-term clinical and radiological outcomes of Partial Pediculotomy, Partial Vertebrotomy (PPPV) Posterior Endoscopic Cervical Decompression (PECD) surgery versus Anterior Cervical Discectomy and Fusion (ACDF) for patients with cervical disc herniations and foraminal pathologies. <i>Materials and Methods</i>: A prospective registry of patients who had undergone either PPPV PECD surgery or ACDF surgery for cervical disc herniation or foraminal pathologies under a single fellowship-trained spine surgeon was performed. The baseline characteristics and operative details including complications were recorded for all included patients. The clinical outcomes evaluated include VAS, MJOA, motor score, and NDI and MacNab’s score. The radiological parameters in neutral-measured facet length, facet area, disc height, C2–C7 angle, neck tilt angle, T1 slope and thoracic inlet angle were also evaluated. <i>Results</i>: A total of 55 patients (29 PPPV PECD, 26 ACDF) were included, with mean follow-up periods of 21.9 and 32.3 months, respectively. Each cohort was noted to have a single case of surgical complication. Statistically significant changes of facet area (49.05 ± 14.50%) and facet length (52.71 ± 15.11%) were noted in the PPPV PECD group. At neutral alignment of the neck on a lateral X-ray, compared to ACDF, PPPV PECD had a statistically significant change in neck tilt angle (−11.68 ± 17.35°) and T1 slope angle (−11.69 ± 19.58°). Whilst both PPPV PECD and ACDF had significant improvements in VAS, MJOA and NDI postoperatively, PPPV PECD was found to be superior across all above scores at various follow-up timepoints compared to its ACDF counterparts. <i>Conclusions</i>: PPPV PECD surgery achieved a satisfactory radiological correction of neck alignment and significantly improved clinical outcomes at medium-term follow-up for our cohort of patients, highlighting its feasibility in treating patients with cervical disc herniations and foraminal pathologies.https://www.mdpi.com/1648-9144/59/7/1222cervical radiculopathyendoscopic spine surgeryposterior endoscopic cervical discectomyposterior endoscopic cervical foraminotomycervical spinecervical endoscopy |
| spellingShingle | Hyeun Sung Kim Pang Hung Wu Brian Zhao Jie Chin Il Tae Jang Clinical and Radiological Outcomes of a Comparative Study of Anterior Cervical Decompression and Fusion with Partial Pediculotomy, Partial Vertebrotomy (PPPV) Posterior Endoscopic Cervical Decompression (PECD) for Cervical Foraminal Pathology Medicina cervical radiculopathy endoscopic spine surgery posterior endoscopic cervical discectomy posterior endoscopic cervical foraminotomy cervical spine cervical endoscopy |
| title | Clinical and Radiological Outcomes of a Comparative Study of Anterior Cervical Decompression and Fusion with Partial Pediculotomy, Partial Vertebrotomy (PPPV) Posterior Endoscopic Cervical Decompression (PECD) for Cervical Foraminal Pathology |
| title_full | Clinical and Radiological Outcomes of a Comparative Study of Anterior Cervical Decompression and Fusion with Partial Pediculotomy, Partial Vertebrotomy (PPPV) Posterior Endoscopic Cervical Decompression (PECD) for Cervical Foraminal Pathology |
| title_fullStr | Clinical and Radiological Outcomes of a Comparative Study of Anterior Cervical Decompression and Fusion with Partial Pediculotomy, Partial Vertebrotomy (PPPV) Posterior Endoscopic Cervical Decompression (PECD) for Cervical Foraminal Pathology |
| title_full_unstemmed | Clinical and Radiological Outcomes of a Comparative Study of Anterior Cervical Decompression and Fusion with Partial Pediculotomy, Partial Vertebrotomy (PPPV) Posterior Endoscopic Cervical Decompression (PECD) for Cervical Foraminal Pathology |
| title_short | Clinical and Radiological Outcomes of a Comparative Study of Anterior Cervical Decompression and Fusion with Partial Pediculotomy, Partial Vertebrotomy (PPPV) Posterior Endoscopic Cervical Decompression (PECD) for Cervical Foraminal Pathology |
| title_sort | clinical and radiological outcomes of a comparative study of anterior cervical decompression and fusion with partial pediculotomy partial vertebrotomy pppv posterior endoscopic cervical decompression pecd for cervical foraminal pathology |
| topic | cervical radiculopathy endoscopic spine surgery posterior endoscopic cervical discectomy posterior endoscopic cervical foraminotomy cervical spine cervical endoscopy |
| url | https://www.mdpi.com/1648-9144/59/7/1222 |
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