Posterior full-endoscopic cervical discectomy in cervical radiculopathy: A prospective cohort study.

OBJECTIVES: This study was conducted to assess the clinical outcomes of using the posterior full-endoscopic cervical discectomy (PECD) in comparison with the conventional anterior cervical decompression and fusion (ACDF) in treating patients with cervical radiculopathy. PATIENTS AND METHODS: From May 2015 to January 2018, patients with single cervical radiculopathy were enrolled in this study. The operative time, blood loss, hospital stay, and perioperative complications were recorded. The Visual Analog Scale (VAS) for neck and arm pain, the Neck Disability Index (NDI), and the modified MacNab criteria were used to quantify the postoperative outcomes. RESULTS: A total of 84 patients were initially enrolled in this study, while three patients were lost during the follow-up. The remaining 81 patients were divided into two groups. Thirty-eight patients underwent conventional ACDF, and the rest 43 patients were treated by PECD procedure. The patients in the ACDF group were slightly older than those in the PECD group (51.4 ± 8.2 VS 46.6 ± 8.8 years old, p = 0.012*). The blood loss and hospital stay were significantly less in patients treated with PECD compared with those undergoing ACDF (p < 0.05*). There were no significant differences in the VAS scores, the NDI, and the modified MacNab criteria between the two groups. The patients in the ACDF group obtained a better Cobb angle and had less operative time compared with those in the PECD group (p < 0.05*). Only mild complications were observed in both groups, with no significant difference (p = 0.28). CONCLUSION: PECD could significantly relieve pain and disability with no severe complication, and the majority of patients were satisfied with this technique. Thus, it is safe and effective to use this procedure in managing patients with cervical radiculopathy as an alternative procedure to ACDF.

Efficacy of Using Platelet-Rich Plasma in Spinal Fusion Surgery-A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Compliant Meta-Analysis.

BACKGROUND: Platelet-rich plasma (PRP) has been frequently used to enhance bone regeneration. A meta-analysis was conducted to systematically assess the fusion rate and pain relief of applying PRP during spinal fusion surgery. METHODS: Studies investigating spinal fusion surgery combined with PRP were retrieved from Medline and the Web of Science in accordance with the inclusion and exclusion criteria. A quality evaluation was conducted using the Cochrane collaboration tool for randomized controlled trials and the Newcastle-Ottawa scale quality assessment for cohort trials. Statistical analysis was performed using RevMan, version 5.3. RESULTS: A total of 12 studies, including 3 randomized controlled trials and 9 cohort studies, with 661 patients, were included in the present meta-analysis. The mean age was 52.3 ± 8.0 years. Overall, the pooled results demonstrated that the differences in the fusion rates between the PRP and non-PRP treatment groups were not statistically significant. The risk ratio was 1.01 (95% confidence interval, 0.95-1.06; P = 0.83). Also, no significant difference in pain relief measured using the visual analog scale was found between the 2 groups. The mean difference was -0.08 (95% confidence interval, -0.26 to 0.11; P = 0.42). CONCLUSIONS: Adding PRP did not increase the fusion rates from spinal fusion surgery. In addition, no significant difference was found in pain relief between the PRP and non-PRP treatment groups.