Spine Center, Jinju Bon Hospital, Jinju-si, Gyeongsangnam-do, Republic of Korea.
Department of Physical Medicine and Rehabilitation, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do, Republic of Korea.
Medicine (Baltimore). 2022 Jul 8;101(27):e29751. doi: 10.1097/MD.0000000000029751.
Biportal endoscopic spine surgery (BESS) for cervical disk herniation (CDH) has been rarely reported. The aim of the article is to describe a novel BESS as a posterior approach for CDH and report the preliminary outcomes and complications. This single-centered retrospective chart review included 109 consecutive patients who underwent BESS for symptomatic single-level CDH. Working and viewing portals were created in each unilateral paravertebral area at the target disk level. Endoscopic exploration allowed for effective and minimally invasive decompression via safe access to the medial foramen with minimal laminectomy and facetectomy. Clinical outcomes, including the visual analog scale, neck disability index, Macnab criteria, and the motor function of the involved arm, were evaluated at 4, 8, 12, and 24 postoperative weeks. Visual analog scale and neck disability index improved significantly at 24 weeks postoperatively (P < .01). According to the Macnab criteria, "excellent," "good," and "fair" results were obtained for 55.9%, 30.3%, and 13.8% of patients, respectively. The post 24-week distribution of the involved upper extremity strength grade was significantly improved compared to the initial value (P = .02). One patient had a motor weakness with a decreased grade over 4 weeks from excessive irrigation. The posterior approach of BESS was efficient and feasible for the treatment of CDH.
经皮内窥镜下颈椎间盘切除术（BESS）治疗颈椎间盘突出症（CDH）的报道较少。本文旨在描述一种新的后路经皮内窥镜下颈椎间盘切除术（BESS）治疗颈椎间盘突出症，并报告初步结果和并发症。本单中心回顾性图表研究纳入了 109 例因单节段 CDH 引起症状而行 BESS 的连续患者。在目标椎间盘水平的每个单侧椎旁区域创建工作和观察通道。内窥镜探查允许通过安全进入内侧孔进行有效和微创减压，最小限度地进行椎板切除术和小关节切除术。在术后 4、8、12 和 24 周评估临床结果，包括视觉模拟量表、颈部残疾指数、Macnab 标准和受累上肢的运动功能。术后 24 周，视觉模拟量表和颈部残疾指数明显改善（P <.01）。根据 Macnab 标准，分别有 55.9%、30.3%和 13.8%的患者获得了“优秀”、“良好”和“一般”的结果。与初始值相比，术后 24 周受累上肢力量分级的分布明显改善（P =.02）。1 例患者因过度冲洗导致 4 周后出现上肢运动无力，肌力下降 1 级。BESS 的后路入路对 CDH 的治疗是有效且可行的。
