Intervertebral disc approach versus nerve root approach in the treatment of cervical spondylotic radiculopathy: a cohort study

Background: With the gradual development of minimally invasive surgery, the treatment of cervical spondylosis is becoming more sophisticated and diversified. However, there was no previous study on the efficacy of intervertebral disc approach and nerve root approach for cervical spondylotic radiculopathy. This trial aims to provide a basis for the clinical treatment of cervical spondylotic radiculopathy by comparing the advantages and disadvantages of the two cutting-edge surgical methods. Methods: Collect relevant information of patients with cervical spondylotic radiculopathy in 3 hospitals and follow up on the postoperative curative effect of the two surgical methods. The improvement of pain and numbness symptoms and cervical spine function were evaluated by NRS, NDI, and Macnab scores, and the postoperative recovery time and the improvement rate of dizziness were comprehensively analyzed. After that, we analyzed the mechanism of the different curative effects of the two surgical methods and found the different characteristics of their therapeutic targets. Results: Compared with before treatment, the NRS scores and NDI scores of the two groups of patients were significantly decreased after treatment (P<0.05). The postoperative NRS score and NDI score of the plasma group were significantly lower than those of the radiofrequency group (2 to 3, 10 to 13, P<0.01), and the therapeutic efficiency of the plasma group was higher than that of the radiofrequency group (82% to 61%, P<0.01). The improvement rate of dizziness symptoms in the plasma group was higher than that in the radiofrequency group (79% to 43%, P<0.05), however, the proportion of people in the radiofrequency group whose symptoms improved within one week after the operation was significantly higher than that in the plasma group (51% to 24%, P<0.01). Conclusions: Both treatment options could effectively relieved the symptoms of patients with cervical spondylotic radiculopathy, but the degree of relief was different. Compared with cervical nerve radiofrequency, cervical intervertebral disc plasma decompression can better relieve upper extremity symptoms in patients with cervical spondylotic radiculopathy, promote the recovery of cervical spine function and improve cervical spondylosis-related dizziness symptoms, which may be closely related to the reduction of the pressure on the internal tissues of the cervical spine.