Cervical spondylosis is a common disease with multiple morbidities, affecting a wide range of people, from 21 to 83 years old, with a prevalence rate of 64.52% or more. Generally speaking, cervical spondylosis is a common disease among middle-aged and elderly people, with a high prevalence between the ages of 40 and 60, and a prevalence of 90% after the age of 70. However, recent studies have shown that the prevalence of cervical spondylosis is trending younger. Although traditional cervical spine surgery has good clinical efficacy, there are some postoperative complications. With the advancement of basic research on cervical spondylosis, diagnostic imaging techniques and minimally invasive surgical techniques, there has been rapid development in minimally invasive treatment of cervical spondylosis in the past 10 years or so.
The current scope of cervical microspine surgical techniques includes.
1, percutaneous puncture spine surgery techniques: percutaneous puncture or tiny incision, using special instruments and devices, to perform minimally invasive spine surgery.
2, spinal microsurgery techniques: the use of the operating microscope or high magnification. Enlarge the surgical field of view for surgical operations.
3, endoscopic-assisted spine surgery techniques: through several skin channels or tiny incisions to the station spine, the use of optical fiber imaging technology under direct vision for surgical operations.
Common cervical microspine surgery procedure features
1, percutaneous puncture spine surgery techniques. Common techniques are divided into.
1, cervical intervertebral disc percutaneous aspiration: suitable for early cervical spondylosis.
2, percutaneous puncture laser vaporization cervical disc decompression: suitable for early cervical spondylosis, the indications and contraindications are still controversial.
3, percutaneous puncture cervical disc nucleoplasty: short clinical application time, limited number of cases.
2.Microsurgery technique of the spine: microscope-assisted anterior cervical spine surgery (this is the main microsurgery of the cervical spine carried out in our hospital).
Advantages
1, not overly pursuing “small incision type of minimally invasive”, but emphasizing “minimally invasive within the incision” and fine operation, thus reducing the incidence of complications. In essence, it is closer to open surgery and is a kind of “micro” open surgery.
2.Improve the accuracy, effectiveness and safety of anterior cervical decompression surgery. The high clarity of the microscopic exposure enables the operator to identify the tiny tissues with great certainty, and the precision and delicacy of its operation can be compared with that of unconventional surgery.
3. Expand the scope of indications for anterior cervical decompression. The improvement of safety makes some cases that are considered more difficult and dangerous to perform anterior decompression and posterior cervical surgery can also be included in the scope of indications.
Disadvantage: the surgical incision is slightly larger than that of endoscopic-assisted cervical spine surgery.
3, endoscopic-assisted spine surgery techniques: cervical disc endoscopic surgery (MED )
Compared with open surgery, the advantages of surgery for cervical spondylosis and cervical disc herniation assisted by discoscopy system: less trauma, better safety, simpler operation, no damage to the cervical bone structure, less influence on the stability of the anterior and posterior columns of the cervical spine, and no influence on the second open surgery. The postoperative neck scar is small.
Disadvantages: narrower indications than microscope-assisted cervical spine surgery; limited microscopic magnification; more complicated operation than microscope-assisted cervical spine surgery.
When choosing whether to undergo minimally invasive cervical spine surgery, patients should understand the following points.
1, the prospect of cervical microsurgery is very exciting, but the current relationship with traditional surgery is complementary to each other and not a substitute for each other.
2. Minimally invasive surgery also has surgical risks, and the view that “it is not too late to do surgery after the invalidation of minimally invasive treatment first” is incorrect.
3. The cervical spine diseases that are suitable for minimally invasive technology have certain limits and are usually more narrowly adapted than conventional surgery.