181: Endoscopic Discectomy vs Collagenase Chemonucleolysis for Single-Level Cervical Disc Herniation

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic neuropathic pain, Non-pharmacological treatments, Assessment and Measurement of Pain/Nociception, Treatment/management

Background and Aims: Posterior Full-Endoscopic Cervical Discectomy (PFECD) and Collagenase Chemonucleolysis (CCNL) are two effective minimally invasive surgical approaches for treating Cervical Spondylotic Radiculopathy (CSR). By analyzing their clinical efficacy, this study aims to provide available insights for the clinical management of CSR.

Methods: A prospective RCT enrolled 64 eligible participants diagnosed with CSR at the Pain Department of the Frist Affiliated Hospital of Anhui Medical University from November 2023 to October 2024. These participants were randomly divided into PFECD (n=32) group and CCNL (n=32) group. Visual Analog Scale (VAS), Japanese Orthopedic Association (JOA) and Neck Disability Index (NDI) scores were compared preoperatively and at scheduled postoperative time points, with efficacy assessed via Modified MacNab Criteria. Disc Height was measured preoperatively and at 12 months after surgery.

Results: All 64 participants completed the follow-up. Both PFECD and CCNL significantly improved postoperative outcomes with VAS and NDI scores significantly decreased and JOA scores increased compared with preoperative values (P < 0.0001). The VAS scores were lower in the PFECD than CCNL group at postoperative day 3 (P < 0.0001). The excellent-and-good rate was 87.50% in the PFECD vs. 81.25% in the CCNL (P > 0.05). No severe adverse events occurred.

Conclusions: Both PFECD and CCNL effectively relieved pain and improved neurological function in patients with cervical disc herniation. PFECD provided faster pain relief, while CCNL offered shorter duration of procedure.

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Presenting Author: Wang Likui
Submitting Author: Likui Wang

Senior Author: Wang Likui

IASP 2026 Global Year theme of Neuropathic Pain: No