Percutaneous cervical discectomy: retrospective comparison of two different techniques

• Published in: Radiologia medica 2020-06, Vol.125 (6), p.569-577
• Main Authors: Ierardi, Anna Maria, Carnevale, Aldo, Cossu, Alberto, Coppola, Andrea, Fumarola, Enrico Maria, Garanzini, Enrico, Silipigni, Salvatore, Magenta Biasina, Alberto, Paolucci, Aldo, Giganti, Melchiore, Carrafiello, Gianpaolo
• Format: Article
• Language: English
• Subjects: Diagnostic Radiology; Fluoroscopy; Identification methods; Imaging; Interventional Radiology; Medicine; Medicine & Public Health; Musculoskeletal Radiology; Neuroradiology; Pain; Patient satisfaction; Radiation dosage; Radiology; Ultrasound
• ISSN: 0033-8362; 1826-6983
• DOI: 10.1007/s11547-020-01133-x

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.