Percutaneous Endoscopic Cervical Discectomy (PECD)

The Percutaneous Endoscopic Cervical Discectomy (PECD) is applied to patients with symptoms of neuralgia by the compression of the shoulder and arm due to the herniation of the disc nucleus from a ruptured annular fiber. Unlike conventional surgery which requires skin incisions and the removal of the whole disc, the procedure preserves most of the disc tissue to minimize complications. It is the most advanced therapy that can be performed on the elderly or patients with diabetes without concern.

Percutaneous Endoscopic Cervical Discectomy(PECD) is a less invasive surgery with inserting the thin canal under local anesthesia. With endoscopic view, the surgeon can insert the 0.4cm canal into the disc through the skin and shrinks the herniated disc with a laser.

The soft cervical disc herniation that has showed no improvement by the physical therapy or exercise would be a main indication. However, it is desirable to treat the patient before the cord compression which might cause severe condition. It is necessary that open surgery should be performed on the patient if the patient cannot run or walk as fast as they normally could, because of a compressed spinal cord.

The Soft Cervical Disc Herniation is defined as when the disc between the vertebral bodies is torn and the nucleus pulposus is herniated so that it could compress the nerve root and spinal cord.

The upper limb neuralgia, which causes pain in the arm, is a common symptom since the nucleus pulposus is usually exited posterolaterally. Also it often causes some pain around the scapula.

Unless the patient is cured, the muscles of the arms and hands could be weakened and the tendon reflex could worsen as well as the sensory neuron could be deteriorated. In a severe case, the patient could have difficulty of walking and could suffer from loss of consciousness or even a stroke.

•Epidural hemorrhage of nerves or fiber attachments around nerves is not created.

•Since disc portions are retranslocated, the need of metallic discs or bone fusion is not necessary.

•Spine instability is almost eliminated.

•The recurrence of disc nucleus inside the nerve cavity can be prevented since the surgery makes a small channel at the front of the cervical disc.

•Recuperation is fast due to the short operation and hospitalization period.

The success rate of Percutaneous Endoscopic Cervical Discectomy (PECD) for the soft cervical herniation is 88%. The rest of them, 7% of the patients showed a relatively fair condition and 5% of the patients required open surgery.

	Open surgery	Percutaneous Endoscopic Cervical Discectomy (PECD)
Indication	All kinds of cervical diseases	Soft cervical disc disease or elderly patients
Characteristic	Open surgery with knife	Minimally invasive spinal surgery with endoscope and laser
Advantage	Broad view Accurate treatment	Characteristic Open surgery with endoscope and laser
Disadvantage	- No cosmetic effects - The operation time is long and it is performed under the general anesthesia. - Demands artificial disc or bone graft Fusion.	- Requires the experienced surgeons due to narrow views. - Needs advanced medical equipment such as endoscope and laser. - Hard cervical disc herniation should be avoided.