1 – Results
Between November 2002 and July 2009 Dr. J. Destandau utilised Endospine to operate on 256 patients with cervical disc herniations.
This is a report of the data concerning these patients and especially the complications encountered. A satisfaction questionnaire is given to each person operated on; it gives information on the time frame in which activities are resumed and determines the Prolo score which evaluates the functional and socio-economic results.
56% of the patients operated on between November 2002 and July 2009 returned their questionnaires (144 out of 256).
The results were excellent in 93% of the cases (134 cases) and poor in 7% of the cases (10 cases).
Of the 119 patients who were working before the operation and who sent back the questionnaire, 108 (91%) returned to work within an average period of 3 weeks and 133 (92%) resumed their normal life within 2 weeks.
98% (141 patients) stated that they were satisfied with the intervention and the supervision and 97% (139 patients) that they had received accurate information.
2 – Sample
The average age of this series of 256 patients was 46 with extremes from 24 to 78.
52.7% were men (135) and 47.3% women (121).
Radiculalgia (pain in the superior limb) was on the left side in 50% of the patients (130), on the right side in 48% (123) and bilateral in 1% of the cases (3).
The herniation was located at C3-C4 level in 3 cases (1%), C4-C5 level in 6 cases (2%), C5-C6 level in 83 cases (32%), C6-C7 level in 143 cases (56%) and C7-T1 level in 21 cases (8%).
106 patients had motor disorders (41%), 97 sensory disorders (38%), and 136 reflex disorders (53%).
3 – Methodology
Each patient receives a questionnaire to be completed and returned at the end of his convalescence. This form gives information on the length of time it takes before leisure activities, work and the activities of daily life are resumed.
After 3 months, if the patient has not resumed his regular activities, the results are considered to be poor even if this occured later.
The results are evaluated using the Prolo criteria, which evaluate the patient’s return to economic and social activities (from 1 to 5) and functional status (from 1 to 5). The two numbers are added and the result gives the Prolo score. The result is judged as excellent when the score is 9 or 10, good for 7 or 8, average for 5 or 6 and poor for less than 5.
4 – Complications
The encountered complications were:
- complications of deep infections: 0
- complications of superficial infections: 0
- access to two levels following poor detection: 0
- an error in the level: 1
- a dural breech: 1
- a partial nerve lesion: 0
None of this 256 patients operated on has been reoperated on.
5 – Post-operative follow-up
The patient stands as soon as awaken.
Physiotherapy starts immediately and the objective is to mobilise the cervical spine and loosen up the paravertebral muscles.
The waterproof dressing allows a normal life, showers and baths in particular.
The return home takes place 24 hours after the operation. No specialised transport is necessary.
Return to former activities including sports is encouraged as soon as possible. No restrictive instructions are given to the patient.