gms | German Medical Science

Objective: Percutaneous cervical nucleoplasty (PCN) is a minimally invasive technique. A portion of the nucleus tissue is ablated using Coblation technique. Resurgery is an important factor for the clinical outcome. However, the rate of subsequent surgery after PCN is still unknown. The aim of this study was to investigate the frequency of an additional open surgery after PCN in a more than ten years’ retrospective.

Methods: Retrospective observational study. Consecutive patients after PCN between 2005 and 2007 were included. The patient’s satisfaction was evaluated with McNab’s outcome criteria. The necessity of an additional open surgery at the cervical spine, the period between PCN and the fusion, and the treated levels were analyzed.

Results: 133 patients were included in this study. All patients were seen one month after PCN. The follow-up time was longer than 5 years in 31.6% of the patients and longer than 10 years in 24.2%. The short-term success rate was 70.7%. However, subsequent surgery was performed in 22.6% of the patients. 56.7 % of the reoperations were done during the first year after PCN. The mean time between PCN and subsequent surgery was 21.4 months. In 86.7% the level of surgery was identical with the index level. In patients with a good result after PCN, subsequent surgery was less frequent and the interval between PCN and additional surgery was significantly larger (P < 0.01).

Conclusion: This is the first study reporting the frequency of re-surgery after PCN. 70.7% patient satisfaction was observed one month after PCN. This result is worsened due to a re-surgery rate of 22.6 %. The data from this study suggests that PCN cannot replace open surgery and that degeneration of the disc is progressive despite or because of PCN. It remains unclear whether there is a group of patients with a good indication for PCN.