European Spine Journal (2018) 27:1460–1468
IDEAS AND TECHNICAL INNOVATIONS
Modied posterior percutaneous endoscopic cervical discectomy
for lateral cervical disc herniation: the vertical anchoring technique
· Qiang Ren
· Lei Chu
· Lei Shi
· Qingshuai Yu
· Zhenjian Yan
· Kexiao Yu
· Chao Liu
· Yang Xiong
· Zhongliang Deng
· Liang Chen
Received: 30 October 2017 / Revised: 14 January 2018 / Accepted: 14 February 2018 / Published online: 24 February 2018
© Springer-Verlag GmbH Germany, part of Springer Nature 2018
Purpose During the long-term practice of percutaneous endoscopic cervical discectomy (PECD) at our institution, we have
modiﬁed the protocol to include the vertical anchoring technique (VAT), which we will describe in detail in this article. The
objective of this study was to compare the clinical outcomes associated with the conventional posterior PECD technique
with that associated with the modiﬁed technique to determine the safety and eﬃcacy of the latter technique.
Methods From December 2014 to January 2016, a total of 44 patients with single cervical disc herniation were randomly
divided into two groups. One group underwent conventional posterior PECD, and the other group underwent posterior PECD
combined with VAT. The operative time, ﬂuoroscopy times and perioperative complications were recorded. The visual analog
scale (VAS) for neck and arm pain and the modiﬁed MacNab criteria at 1 day, 3, 6, and 12 months after surgery were used
to evaluate the postoperative outcomes.
Results All patients underwent surgery successfully without severe complications. The operative time and intraoperative
ﬂuoroscopy times were signiﬁcantly less in patients treated with VAT than in those who underwent conventional posterior
PECD (P < 0.05). Both types of surgery signiﬁcantly improved the symptoms of patients. According to the results of the
follow-up period, there were no signiﬁcant diﬀerences in VAS scores for neck and arm pain or the modiﬁed MacNab criteria
between the two groups (P > 0.05). There was no recurrence in either group during the follow-up period.
Conclusions Although the clinical outcomes of the two surgical techniques were similar, the VAT decreased the operative
time and intraoperative ﬂuoroscopy times in posterior PECD surgery. The learning curve for posterior PECD could be
shortened by using the VAT.
Graphical abstract These slides can be retrieved under Electronic Supplementary Material.
1. percutaneous endoscopic cervical discectomy(PECD)
3. lateral cervical disc herniation
4. vertical anchoring technique (VAT)
Demonstration of the vertical anchoring technique in posterior PECD
A-B: Both the Kirschner wire and trephine were used to create the artificial bone
mark; C: The anatomical structures were easier to identify using the vertical
anchoring technique in PECD.
Take Home Messages
1. The vertical anchoring technique(VAT) in posterior PECD
is a safe, slightly modified and effective procedure.
2. The VAT shortens the operative time and reduces the
intraoperative fluoroscopic time and learning curve.
Conggang Liao and Qiang Ren contributed equally to this paper.
Electronic supplementary material The online version of this
article (https ://doi.org/10.1007/s0058 6-018-5527-y) contains
supplementary material, which is available to authorized users.
Extended author information available on the last page of the article