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Comparative Study
. 2025 Apr 10;25(1):164.
doi: 10.1186/s12871-025-03047-5.

The effect of posterior percutaneous endoscopic cervical discectomy vs. percutaneous nucleoplasty in patients with cervical radicular pain due to a single-level contained soft-disc herniation: a retrospective cohort study

Jun Hu #  1 , Zi Wang #  1   2 , Yuyu Guo #  1 , Liuhu Han  1 , Liyang Chen  1 , Likui Wang  3
Affiliations
Comparative Study

The effect of posterior percutaneous endoscopic cervical discectomy vs. percutaneous nucleoplasty in patients with cervical radicular pain due to a single-level contained soft-disc herniation: a retrospective cohort study

Jun Hu et al. BMC Anesthesiol. .

Abstract
in English, French

Introduction: Cervical radicular pain (CRP) is a common disorder among adults. Minimally invasive surgical techniques, such as posterior percutaneous endoscopic cervical discectomy (PPECD) and percutaneous cervical nucleoplasty (PCN) are considered when conservative treatment fails to contain severe persistent pain. Our retrospective study evaluated the clinical outcomes of CRP in patients treated with PPECD and PCN.

Methods: Between May 2019 and June 2021, 67 patients with CRP, due to single-level contained soft-disc herniation, were treated with either PPECD or PCN. Clinical outcomes were assessed by the numerical rating scale (NRS), Neck Disability Index (NDI), and modified Macnab criteria. Pre- and postoperative clinical parameters were also compared.

Results: Compared with the preoperative values, the mean NRS scores for radicular arm pain and NDI score improved significantly with both treatments. According to the Macnab criteria, patients with PPECD (82.9%) had a higher clinical success rate than patients with PCN (75.0%), however, this difference was not statistically significant (P = 0.5508). No major complications were observed in any patients.

Conclusions: Both PPECD and PCN are effective and safe options for CRP patients with persistent, and severe pain. Given the absence of superiority in pain relief and clinical outcomes with PPECD, we suggest that the shorter operation time and the less invasive features of PCN is an alternative to PPECD in patients with single-level contained soft-disc herniation.

Clinical trial number: Not applicable.

Cervical radiculopathy with persistent severe pain is amenable to minimally invasive surgery with either posterior percutaneous endoscopic cervical discectomy (PPECD) or percutaneous cervical nucleoplasty (PCN) with equipoise for outcomes. In this retrospective study, we found that both PPECD and PCN are effective and safe options for patients with CRP. Considering the shorter operation time and the minimally invasive features of PCN technique, we argue that PCN can be a good alternative to PPECD in patients with single-level contained soft-disc herniation.

Keywords: Cervical radicular pain; Low-temperature plasma radiofrequency ablation; Percutaneous cervical nucleoplasty; Posterior percutaneous endoscopic cervical discectomy; Single-level contained soft-disc hernia.

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Conflict of interest statement

Declarations. Human ethics and consent to participate: Not applicable. Consent to participate is covered by the informed consent. Institutional review boards approved informed consent documentation, study protocols and amendments. The reference number of the ethics approval letter approved by the Ethics Committee of the First Affiliated Hospital of Anhui Medical University is PJ2022-01-26. All investigations were carried out in compliance with the Helsinki Declaration. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
A 57-year-old female patient presented with neck and left arm pain. Endoscopic image showing a herniation (a) and decompression of the nerve root (b). Preoperative T2-weighted MRI showed a herniation (white arrow) at the C5/6 level (c), and the herniation was removed on postoperative (3 months) MRI scans (d)
Fig. 2
Fig. 2
A 63-year-old female patient presented with right arm pain. Intraoperative CT scans showing a herniation (blue arrow) on the right side, surface markers (white arrow), and the designed needle route (white triangle and line) (a). Intraoperative CT scans showing volumetric reduction of the tissue of the nucleus pulposus after coalition (b). Preoperative T2-weighted MRI showed a herniation (white arrow) at the C5/6 level (c), and the herniation was disappeared oin postoperative (3 months) MRI scans (d)
Fig. 3
Fig. 3
The intensity of arm pain (a) and Neck Disability Index (b) between treatment groups at all measurement moments. Data are presented as mean (standard deviation). PEECD, posterior percutaneous endoscopic cervical discectomy; PCN, percutaneous cervical nucleoplasty
See this image and copyright information in PMC

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