Evaluation of natural resorption of herniated cervical intervertebral disc with different degrees of degeneration after cervical microendoscopic laminoplasty by three-dimensional volume method

doi:10.12307/2021.351

Abstract

Abstract: BACKGROUND: Previous studies have suggested that the resorption of herniated nucleus pulposus of herniated cervical intervertebral disc is related to the type and location of herniation. It is unclear whether the degree of degeneration of herniated cervical intervertebral disc will affect the occurrence of resorption of herniated nucleus pulposus phenomenon.
OBJECTIVE: To observe the absorption of intervertebral discs with different degrees of degeneration after cervical microendoscopic laminoplasty, and analyze its characteristics and possible mechanism, providing a more reasonable strategy and basis for the treatment of cervical spondylotic myelopathy.
METHODS: Retrospective study was conducted to analyze the general data and imaging data of 54 patients with cervical spondylotic myelopathy who underwent cervical microendoscopic laminoplasty from January 2014 to January 2020 in the First Affiliated Hospital of Zhengzhou University. Miyazaki grading criteria were used to evaluate the degree of cervical disc degeneration and grouping. Three-dimensional volume method was used to measure the volume of cervical herniated discs before operation and at the last follow-up. The absorption rate and absorption ratio were used to evaluate the occurrence of resorption of herniated nucleus pulposus. The Japanese Orthopaedic Association score was used to evaluate the clinical efficacy.
RESULTS AND CONCLUSION: (1) All the 54 patients were followed up, including 29 males and 25 females, aged 54.81±9.76 years old. The course of disease was 10.54 ± 8.48 months. The follow-up time was 10 days to 76 months. (2) A total of 159 cervical herniated discs were observed, of which 87.42% (139/159) were absorbed to varying degrees. (3) Due to the small number of grades I and V, they were not included in the statistical analysis. The absorption rate and absorption ratio of grade II degeneration group, grade III degeneration group and grade IV degeneration group were (40.60±25.72)%, (36.12±18.30)%, (37.49±27.95)% and 85.42%(41/48), 89.23%(58/65), 87.50%(35/40), respectively, and there was no significant difference between the groups (P > 0.05). (4) Among the 139 herniated cervical discs with resorption of herniated nucleus pulposus, 77.70% (108/139) had no change in degeneration grade, and 22.30% (31/139) had an increase in degeneration grade; among them, 22 changed from grade II to grade III, and 9 changed from grade III to grade IV. (5) In 54 cases of cervical spondylotic myelopathy, 20 cases were excellent; 27 cases were good; and 7 cases were fair; and the excellent and good rate was 87%. (6) The results show that the resorption of herniated nucleus pulposus phenomenon after cervical microendoscopic laminoplasty has nothing to do with the degree of degeneration of the herniated cervical intervertebral disc. It suggests that the cervical microendoscopic laminoplasty can cause long-term and stable resorption of herniated nucleus pulposus in cervical spondylotic myelopathy patients with different degeneration of herniated cervical discs, which is beneficial to improve the long-term treatment effect. It provides a new strategy and basis for the treatment of cervical spondylotic myelopathy.

Key words: cervical spondylotic myelopathy, endoscopy, minimally invasive, cervical laminoplasty, resorption of herniated nucleus pulposus, degree of cervical disc degeneration, Miyazaki grading criteria

CLC Number:

Li Long, Zhang Chunlin, Shao Chenglong, Yan Xu, Wang Yongkui, Liu Xiaokang, Li Dongzhe. Evaluation of natural resorption of herniated cervical intervertebral disc with different degrees of degeneration after cervical microendoscopic laminoplasty by three-dimensional volume method[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(36): 5832-5837.

Figures/Tables 4

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