Evaluation Of Treatment To Cervical Spondylitic Radiculopathy With Radiofrequency Ablation And Chemonucleolysis With Low-dose Collagenase

ObjectiveTo investigated the safeties and effects of the combination of Radiofrequency ablation and chemonucleolysis with low-dose collagenase for treatment of cervical spondylotic radiculopathy (CSR).Methods25patients with CSR were included in the research according to the strict standard, and27discs must be operated with the combination of the minimally invasive treatments. The patients were performed by the same physician who be had high qualification. The visual analogue scale (VAS) and PACS system tools was be evaluated; Intervertebral foramen diameter (IFD), disc height (DH), protrusions length(PL), width (PW) and protrusion area (PA) also measured and evaluated surgical treatment safety and effect by the magnetic resonance imaging (MRI) and Odom standard. The time points of pre-operation, terminal of treatment and3months after postoperative were recorded, and analyzed by SPSS17statistics software.ResultsThe pathological disc in the operation imaging can be divided into well-distributed dispersion type, fracturing diffuse, point-shaped diffuse by discography. Comparing to the VAS1(4.18±0.49cm), DH1(4.18±0.49mm), PL1(8.16±1.25mm), PW1(5.94±1.77mm) and PA1(48.65±23.08) at the time of initial treatment, the VAS2(0.73±0.71cm) at the terminal of treatment, and VAS3(0.70±0.58cm), DH3(3.98±0.44mm), PL3(3.97±1.39mm), PW3(2.62±0.56mm) and PA3(14.36±4.35mm) after3months was significantly decreased (P<0.001); however, IFD3(3.04±0.67mm) at the time of3months after hospital discharge was significantly increased than IFD1(0.65±1.11mm) at the initial treatment (P<0.001). In terminal treatment, the clinical cure rate by Odom standard was92.0%, and3months after hospital was96.0%.Conclusion The combination application of Radiofrequency ablation and chemonucleolysis with low-dose collagenase to treat CSR was safe and effective. They could reduce the symptoms and pressure in the responsible disc of patient and make the big protrusion disappeared very well with their advantages, meanwhile they could keep function of responsible disc mostly.