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Changes in cervical sagittal alignment after single-level posterior percutaneous endoscopic cervical diskectomy
Chi Heon Kim1, Kyung-Hyun Shin2, Chun Kee Chung3
1Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea ; Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea ; Clinical Research Institute, Seoul National University Hospital, Seoul, South Korea.
Posterior percutaneous endoscopic cervical diskectomy (PECD) is a safe procedure for foraminal disk herniation. This study found that PECD does not worsen cervical lordosis, even in patients with pre-existing reduced lordosis.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Surgery
Background:
- Posterior percutaneous endoscopic cervical diskectomy (PECD) offers disk preservation for foraminal disk herniations.
- Progressive angulation in the operated cervical segment is a potential concern post-PECD, particularly in patients with cervical lordosis < 10 degrees.
Purpose of the Study:
- To analyze the change in cervical lordosis following posterior PECD in patients with single-level foraminal soft disk herniation.
- To assess the impact of PECD on cervical curvature and segmental alignment.
Main Methods:
- A retrospective review of 32 consecutive patients undergoing single-level posterior PECD for foraminal disk herniation.
- Radiographic assessment of cervical curvature (C2-7), segmental angle (SA), and disk height at the operative level preoperatively and at a mean follow-up of 30 months.
- Analysis of changes in cervical lordosis, specifically comparing patients with initial lordosis < 10 degrees versus >= 10 degrees.
Main Results:
- 91% of patients reported no or minimal pain at the last follow-up.
- No significant changes were observed in segmental angle (SA), anterior disk height (AH), or posterior disk height (PH).
- Cervical curvature significantly worsened in patients with initial lordosis < 10 degrees (p=0.01) but not in those with lordosis >= 10 degrees (p=0.24).
Conclusions:
- Posterior PECD does not lead to a significant worsening of overall cervical curvature.
- The procedure appears safe regarding cervical alignment, with no detrimental changes in segmental angle or disk height.
- While some patients with pre-existing reduced lordosis showed a trend towards increased curvature, the overall cervical alignment is maintained post-PECD.
