Abstract

Study design. Retrospective clinical data analysis.Object. To compare clinical results of open anterior cervical discectomy with minimally invasive technique of percutaneous endoscopic discectomy in soft disc herniation.Mateirals and Methods. Between 2001 and 2006, there were 36 patients in the open anterior cervical discectomy with fusion and 41 patients who underwent percutaneous anterior endoscopic cervical herniotomy with laser assistance. All the patients presented with cervicobrachial neuralgia, had shown a complete lack of progress from conservative treatment for at least the previous 6 months. We excluded the patients with cervical stenosis due to marked spondylosis, and with myelopathy. We evaluated the patients by pre- and postoperative VAS (Visual Analogue Scale), NDI (Neck Disability Index) scores, PSR (Patient Satisfaction Rate), hospital stay, and operative time.Results. The mean duration for follow-up was 4 years (range, 2-7 years). The mean NDI scores for neck and arm decreased, respectively, from 6.6 and 8.0 to 1.6 and 1.7 in the ACDF group and from 8.1 and 8.1 to 3.0 and 3.2 in the PECH group. The mean NDI scores improved from 59.4 to 13.0% in the ACDF group and from 59.0 to 23.0% in the PECH group. In both groups, the VAS and NDI scores significantly changed from pre- to post-operatively (P < 0.05). Patients with ACDF had significantly decreased in VAS (Arm) and NDI compared with patients with PCD (P < 0.05).Also, the length of hospital stays, operative time, and rate of return to work were greater for the PECH compared with the ACDF.Conclusions. The results of laser-assisted cervical endoscopic discectomy compare favorable with open anterior discectomy and avoid complications associated with bon grafting for fusion. Although there are decreased in disc height and residual pain, PECH can preserve cervical alignment and segmental motion. In addition, patient satisfaction with minimally invasive technique is based upon scheduling, avoiding general anesthesia and blood transfusion, outpatient surgery, and rapid return to routine activities. PECH is a safe and effective minimally invasive surgical option for soft (ruptured) disc herniation in selected patients.