[Postoperative outcomes after simultaneous surgery for cervical radiculopathy combined with distal peripheral nerve compression].

Abstract

To date, the optimal therapeutic and diagnostic strategy in patients with simultaneous clinical manifestations of degenerative cervical spine disease and upper-extremity nerve compression is still unclear.

Objective: To analyze the results of simultaneous surgical interventions in patients with cervical radiculopathy combined with distal peripheral compression-induced ischemic neuropathy.

Material and methods: We retrospectively studied postoperative outcomes in 23 patients with two-level degenerative cervical spine disease with radiculopathy and peripheral nerve compression (cubital canal, Guyon's canal or carpal tunnel syndromes). Two surgical teams performed interventions. Technical features of interventions, postoperative characteristics, clinical parameters (VAS scores of pain, NDI, SF-36 and DASH scores) and complications according to the Dindo-Clavien classification were studied.

Results: Mean surgery time was 104 min, blood loss - 75 ml, length of hospital-stay - 4 days. In long-term period, cervical pain score decreased from 73 (57;88) to 6 (3;11) mm (p=0.006), pain in upper extremities from 85 (74;95) to 3 (2; 5) mm (p=0.001), NDI from 74 (60; 86) to 6 (6;10) (p=0.001) points. Physical component of health increased from 26.12 (19.37; 35.51) to 52.26 (50.68; 56.42) (p=0.007) scores, psychological component - from 32.68 (18.57;40.52) to 54.92 (50.73;56.92) scores (p =0.003). DASH score of upper limb function improved from 74 (62;80) to 8 (6;10) points. There were 3 (13%) minor complications Dindo-Clavien grade I, II and IIIA after cervical spine surgery and 2 (8.7%) events after peripheral nerve repair. Only 1 (4.3%) serious complication (Grade IIIB, IV and V) was identified after cervical spine surgery.

Conclusion: Simultaneous surgery for cervical radiculopathy combined with peripheral nerve compression is safe and effective for appropriate patients.