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[Long-term effectiveness of percutaneous laser disc decompression in treatment of cervical spondylosis]
Hui Qin1, Kangren Li, Shanjun Fan
1Department of Orthopedics, No.3 People's Hospital of Chengdu, Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu Sichuan 610031, PR China. q999h@sohu.com
Objective:
To retrospectively analyze the long-term effectiveness of percutaneous laser disc decompression (PLDD) in treatment of cervical spondylosis.
Methods:
Between March 2003 and June 2005, 156 patients with cervical spondylosis were treated with PLDD. There were 74 males and 82 females with an average age of 55.4 years (range, 31-74 years). The disease duration varied from 2 months to 15 years. Fifty-nine patients were classified as cervical spondylotic radiculopathy, 48 as vertebral-artery-type cervical spondylosis, 19 as cervical spondylotic myelopathy, and 30 as mixed type spondylosis. The lesions were located at the levels of C3, 4 in 32 discs, C4, 5 in 66 discs, C5, 6 in 89 discs, and C6, 7 in 69 discs, and including 71 one-level lesion and 85 multi-level lesions. All cases were followed up to study the long-term effectiveness and correlative factors.
Results:
A total of 117 (75%) patients' symptoms were lightened or eased up immediately after operation. Discitis occurred in 1 case at 3 days after operation and was cured after 3 weeks of antibiotic use. All patients were followed up 5 years to 7 years and 3 months (5 years and 6 months on average). According to Macnab criteria, the long-term effectiveness was excellent in 60 cases (38.46%), good in 65 cases (41.67%), fair in 19 cases (12.18%), and poor in 12 cases (7.69%); the excellent and good rate was 80.13%. No significant difference was observed in the wedge angels and displacements of the intervertebral discs between before and after operations (P > 0.05). Multiple-factors logistic regression showed that the disease duration and patient's age had obvious relationship with the effectiveness of treatment (P < 0.05), while the type of cervical spondylosis, disc protrusion degree, mild cervical instability, and lesion scope had no correlation with the effectiveness of treatment (P > 0.05).
Conclusion:
PLDD is safe and effective in treatment of cervical spondylosis with less complication. There is no impact on the stability in cervical spinal constructs. The disease duration and patient's age have obvious impact on the long-term effectiveness of treatment. The type of cervical spondylosis, disc protrusion degree, cervical instability, and lesion scope are not the correlative factors.
