Minimally invasive percutaneous procedure for the treatment of a contained cervical disc herniation - a preliminary prospective study.

PURPOSE: This study evaluated the efficacy of a minimally invasive cervical procedure that combines percutaneous nucleoplasty, annuloplasty, and manual nucleotomy in patients with internal annular rupture or contained disc protrusion accompanied by cervicogenic symptoms. PATIENTS AND METHODS: Seventeen patients presenting with cervical radiculopathy and associated complaints - such as headache, vertigo/tinnitus, or facial numbness - underwent treatment with the Disc-FX Mini technique. A control group of 15 individuals with similar clinical and radiological findings received conservative therapy. Pain intensity and functional status were assessed using the Visual Analogue Scale (VAS) and the Neck Disability Index (NDI) at baseline and during follow-up. Psychological examination was performed to exclude any psychological background of ailments. RESULTS: In the treated group, the mean VAS scores dropped from 8.1 ± 1.2 at baseline to 1.6 ± 1.0 at one year, while the NDI scores improved from 29.8 ± 6.8 to 7.6 ± 2.3. The control group showed smaller improvement (VAS from 7.5 ± 1.4 to 3.9 ± 1.2; NDI from 26.0 ± 9.6 to 12.1 ± 6.1). Of 13 patients reporting persistent or recurrent headache in the treatment group, 9 reported relief of these symptoms. Vertigo and other atypical symptoms subsided or markedly decreased in most cases. CONCLUSIONS: This combined percutaneous method may represent a safe and effective option for patients with cervicogenic symptoms who are unresponsive to conservative management. It potentially bridges the gap between ineffective conservative treatment and open surgery, particularly for patients with subtle imaging findings.