title: Changes in cervical sagittal alignment after single-level posterior percutaneous endoscopic cervical diskectomy.
abstract: Study Design Case series. Objective Posterior percutaneous endoscopic cervical diskectomy (PECD) can preserve the disk in patients with a foraminal disk herniation. However, progressive angulation at the operated segment is a concern, especially for patients with cervical lordosis < 10 degrees. The change in cervical lordosis after posterior PECD was analyzed. Methods Medical records were reviewed of 32 consecutive patients (22 men, 10 women; mean age, 49 ± 12 years) who had single-level foraminal soft disk herniation. The operation levels were as follows: C4-5 in 1 patient, C5-6 in 12, C6-7 in 18, and C7-T1 in 1. All patients were discharged the day after the operation, and neck motion was encouraged. All patients were followed for 30 ± 7 months (range, 24 to 46 months), and 21/32 patients (66%) had radiographs taken at 25 ± 11 months (range, 12 to 45 months). Radiologic parameters were assessed, including cervical curvature (C2-7), segmental Cobb's angle (SA), and anterior and posterior disk height (AH and PH, respectively) at the operative level. Results At the last follow-up, 29/32 patients (91%) had no or minimal pain, and 3/32 patients had occasional pain. SA, AH, and PH were not significantly changed. Cervical lordosis < 10 degrees was present in 10/21 patients preoperatively and in 3/21 patients at the last follow-up. For patients with cervical lordosis < 10 degrees, cervical curvature changed from -2.5 ± 8.0 to -11.3 ± 9.3 degrees (p = 0.01). For patients with cervical lordosis ≥ 10 degrees, cervical curvature changed from -17.5 ± 5.8 to -19.9 ± 5.7 degrees (p = 0.24). Conclusions Cervical curvature does not worsen after posterior PECD.
authors: Department 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.
authors: Chi Heon
authors: CH
authors: Kim
authors: Department of Orthopedic Surgery, Shin Hospital, Kyung-Gi, Seoul, South Korea.
authors: Kyung-Hyun
authors: KH
authors: Shin
authors: Department 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 ; Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea.
authors: Chun Kee
authors: CK
authors: Chung
authors: Department of Neurosurgery, Seoul National University College of Medicine, Seoul, South Korea ; Department of Neurosurgery, Seoul National University Boramae Hospital, Seoul, South Korea.
authors: Sung Bae
authors: SB
authors: Park
authors: Department 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.
authors: Jung Hee
authors: JH
authors: Kim
keywords: alignment; cervical vertebrae; disk; diskectomy; percutaneous; spine
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