Won-Chul Choi, Sang-Ho Lee, Yong Ahn, Seungcheol Lee, Byung Kwan Choi, Song-Woo Shin

Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Korea

Keywords: Cervical vertebrae; decompression, surgical/methods; diskectomy, percutaneous/methods; intervertebral disk displacement/surgery; treatment outcome.


Objectives: Percutaneous endoscopic cervical discectomy is an effective minimally invasive procedure for cervical soft disc herniation. However, this procedure cannot be applied in patients with cervical disc herniation accompanied by segmental instability. Recently developed WSH Cervical B-Twin can be used as an interbody spacer to achieve stability without open discectomy and fusion. The aim of this study was to present the surgical technique of percutaneous cervical stabilization with the use of the WSH Cervical B-Twin and to evaluate its results.
Patients and methods: Seventeen consecutive patients (11 males, 6 females; mean age 48.8 years; range 30 to 65 years) underwent the index surgery between March 2001 and August 2004. The mean duration of symptoms was 38.8 months (range 6 to 120 months). Preoperative evaluations were made using computed tomography, magnetic resonance imaging, dynamic X-rays, and provocative discography. All the procedures were performed under local anesthesia and on an outpatient basis. Neck pain was evaluated by the visual analog scale (VAS). The mean follow-up was 26.6 months (range 5 to 46 months).
Results: The mean hospital stay was 12 hours. The mean VAS score for neck pain significantly decreased (p<0.001). A favorable outcome was achieved in 13 patients (76.5%) with recovery rates ranging from 40% to 90%. Four patients (23.5%) had no symptomatic improvement. Two patients (11.8%) required open surgery because of incomplete decompression. No permanent neurological deficits, infections, or procedure-related complications were encountered.
Conclusion: In selected cases, percutaneous cervical stabilization using the WSH Cervical B-Twin is a safe and effective procedure for cervical disc herniation with segmental instability.