Anna Maria Ierardi1, Aldo Carnevale2, Alberto Cossu3, Andrea Coppola4, Enrico Maria Fumarola5, Enrico Garanzini5, Salvatore Silipigni6, Alberto Magenta Biasina5, Aldo Paolucci7, Melchiore Giganti3, Gianpaolo Carrafiello8. 1. Diagnostic and Interventional Radiology Department, ASST Santi Paolo e Carlo, San Paolo Hospital, University of Milan, Via A di Rudinì 8, 20142, Milan, Italy. amierardi@yahoo.it. 2. Radiology Department, Sant'Anna University Hospital, Via Aldo Moro 8, 44124, Ferrara, Italy. 3. Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Via L. Ariosto 35, 44121, Ferrara, Italy. 4. Radiology Department, ASST Sette Laghi, University of Insubria, Varèse, Italy. 5. Diagnostic and Interventional Radiology Department, ASST Santi Paolo e Carlo, San Paolo Hospital, University of Milan, Via A di Rudinì 8, 20142, Milan, Italy. 6. Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy. 7. Department of Neuroradiology (F.T.), Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy. 8. Unità Operativa di Radiologia, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
Abstract
AIM: To compare clinical success and patient satisfaction of percutaneous cervical nucleoplasty (PCN) and percutaneous cervical discectomy (PCD) in contained cervical disc herniation treatment. MATERIALS AND METHODS: We retrospectively identified 50 consecutive patients in our institution: 24 underwent the PCD treatment and 26 patients were treated by the PCN procedure. All patients complained of radicular pain with or without neck pain; diagnosis of contained cervical disc herniation was obtained by MRI; all patients had received conservative therapy which did not result in symptom improvement. Exclusion from our series consisted of patients who had undergone previous surgery at the indicated level, or those with myelopathy, or those in whom more than a sole herniation was treated in the same session. Overall procedure time, fluoroscopy time, radiation dose and complications were recorded. The MacNab scale score was used to assess clinical success in terms of pain relief at 2- and 6-month follow-up. After 4-6 months, a cervical MRI was obtained in 24 patients. RESULTS: Neither major nor minor complications were reported. Regarding patient satisfaction, overall median modified MacNab score was excellent both at 2 and 6 months after treatment. No significant statistical difference was found in mean modified MacNab score at 2 and 6 months among patients grouped by treatment choice (p = 0.319 and 0.847, respectively); radiation dose was inferior in PCN group than in PCD, with no significant statistical difference. CONCLUSION: PCD and PCN were found to be safe and effective in terms of pain relief in contained cervical herniation treatment.
AIM: To compare clinical success and patient satisfaction of percutaneous cervical nucleoplasty (PCN) and percutaneous cervical discectomy (PCD) in contained cervical disc herniation treatment. MATERIALS AND METHODS: We retrospectively identified 50 consecutive patients in our institution: 24 underwent the PCD treatment and 26 patients were treated by the PCN procedure. All patients complained of radicular pain with or without neck pain; diagnosis of contained cervical disc herniation was obtained by MRI; all patients had received conservative therapy which did not result in symptom improvement. Exclusion from our series consisted of patients who had undergone previous surgery at the indicated level, or those with myelopathy, or those in whom more than a sole herniation was treated in the same session. Overall procedure time, fluoroscopy time, radiation dose and complications were recorded. The MacNab scale score was used to assess clinical success in terms of pain relief at 2- and 6-month follow-up. After 4-6 months, a cervical MRI was obtained in 24 patients. RESULTS: Neither major nor minor complications were reported. Regarding patient satisfaction, overall median modified MacNab score was excellent both at 2 and 6 months after treatment. No significant statistical difference was found in mean modified MacNab score at 2 and 6 months among patients grouped by treatment choice (p = 0.319 and 0.847, respectively); radiation dose was inferior in PCN group than in PCD, with no significant statistical difference. CONCLUSION:PCD and PCN were found to be safe and effective in terms of pain relief in contained cervical herniation treatment.
Entities:
Keywords:
Cervical disk herniation; Discectomy; Nucleoplasty; Percutaneous
Authors: Judith Divera de Rooij; Pravesh Shankar Gadjradj; Hans Aukes; George Groeneweg; Caroline Margina Speksnijder; Frank Johannes Huygen Journal: J Pain Res Date: 2022-05-17 Impact factor: 2.832