Comparative efficacy of unilateral biportal endoscopic and full-endoscopic posterior cervical foraminotomy in the treatment of cervical spondylotic radiculopathy: a retrospective analysis.

The aim of this study was to compare the clinical efficacy of the full-endoscopic posterior cervical foraminotomy (FE-PCF) and the unilateral biportal endoscopic posterior cervical foraminotomy (UBE-PCF) in the treatment of cervical spondylotic radiculopathy (CSR). Patients who underwent posterior cervical spine surgery in our hospital from January 2020 to December 2022 were retrospectively analyzed. According to the surgical method, the patients were divided into two groups: FE-PCF group and UBE-PCF group. Perioperative data included operation time, Intraoperative blood loss and postoperative hospital stay were collected. The Visual Analog Scale (VAS)-arm, VAS-neck, and Neck Diability Index (NDI) was used to evaluate the clinical outcomes at preoperative, postoperative 1 week and Last follow-up. Serum creatine phosphokinase (CPK) and C-reactive protein (CRP) levels were recorded to evaluate surgical invasiveness. A total of 160 patients were included, including 89 cases of FE-PCF and 71 cases of UBE-PCF. The demographic and preoperative data showed no significant differences between the two groups (P > 0.05). The mean operating time was significantly shorter in the UBE-PCF group compared to FE-PCF group (P < 0.05). Serum CRP and CPK levels of the two groups both exhibited a pattern of rising and then falling, peaking one day following surgery and decreasing to near normal values three days after the operation. Compared with preoperative, both groups showed significant improvement in postoperative VAS and NDI scores, with a statistically significant difference (P < 0.05). However, the differences in results between the groups were not significant. Both UBE-PCF and FE-PCF are secure and efficient methods for treating CSR by continuous visualization. UBE-PCF offers predictable and adequate decompression within a reduced surgical duration, facilitated by its separate observation and operation channels.

Tang Z ，Jian L ，Liu Y ，Niu W ，Tan J ，Shen M ，Yang H ... -  《-》

Comparison of clinical efficacy of posterior percutaneous endoscopic cervical discectomy versus unilateral biportal endoscopy key-hole techniques for cervical spondylotic radiculopathy: a retrospective study with 2 years.

To compare the clinical efficacy of posterior percutaneous endoscopic cervical discectomy (PECD) with unilateral biportal endoscopy (UBE) key-hole techniques for treating cervical spondylotic radiculopathy (CSR). A retrospective study was performed for patients with CSR treated by PECD (n = 40) and UBE (n = 30). Patients background, operative data, and radiographic measurements were obtained. The visual analog scale (VAS) and neck disability index (NDI) were recorded preoperatively and 3 months and 2 years postoperatively, and modified Macnab criteria was recorded at 2 years postoperatively. The background data of the two treatment groups were similar. There was no significant difference in hospitalization or fluoroscopy times (P > 0.05), whereas, the UBE group had shorter operative time and longer incision length than those of the PECD group (p < 0.001). There was a statistically significant difference in the postoperative cervical sagittal vertical axis compared to preoperative measurement (PECD: p = 0.009; UBE: p = 0.010). The VAS and NDI significantly improved in each time period in both groups (p < 0.001). The excellent/good rates were 87.5% in the PECD group and 90.0% in the UBE group. One case of postoperative nerve root irritation symptoms occurred in the PECD group and one case of mild spinal cord injury occurred in the UBE group. UBE, as well as PECD, was recommended as an option for CSR because of easy operation, minimal invasiveness, high safety profiles, and satisfactory clinical efficacy.

Zhang Y ，Dai J ，Dai G ，Zhan W ，Wang Y ，Hu P ... -  《Journal of Orthopaedic Surgery and Research》

Unilateral biportal endoscopic decompression versus anterior cervical decompression and fusion for unilateral cervical radiculopathy or coexisting cervical myelopathy: a prospective, randomized, controlled, noninferiority trial.

Cervical spondylosis (CS), including myelopathy and radiculopathy, is the most common degenerative cervical spine disease. This study aims to evaluate the clinical outcomes of unilateral biportal endoscopy (UBE) compared to those of conventional anterior cervical decompression and fusion (ACDF) for treating unilateral cervical radiculopathy or coexisting cervical myelopathy induced by unilateral cervical herniated discs. A prospective, randomized, controlled, noninferiority trial was conducted. The sample consisted of 131 patients who underwent UBE or ACDF was conducted between September 2021 and September 2022. Patients with cervical nerve roots or coexisting spinal cord compression symptoms and imaging-defined unilateral cervical radiculopathy or coexisting cervical myelopathy induced by unilateral cervical herniated discs were randomized into two groups: a UBE group (n = 63) and an ACDF group (n = 68). The operative time, blood loss, length of hospital stay after surgery, and perioperative complications were recorded. Preoperative and postoperative modified Japanese Orthopaedic Association (mJOA) scale scores, visual analog scale (VAS) scores, neck disability index (NDI) scores, and recovery rate (RR) of the mJOA were utilized to evaluate clinical outcomes. The hospital stay after surgery was significantly shorter in patients treated with UBE than in those treated with ACDF (p < 0.05). There were no significant differences in the neck or arm VAS score, NDI score, mJOA score, or mean RR of the mJOA between the two groups (p < 0.05). Only mild complications were observed in both groups, with no significant difference (p = 0.30). UBE can significantly relieve pain and disability without severe complications, and most patients are satisfied with this technique. Consequently, this procedure can be used safely and effectively as an alternative to ACDF for treating unilateral cervical radiculopathy or coexisting cervical myelopathy induced by unilateral cervical herniated discs. This study was registered in the Chinese Clinical Trial Registry on 02/08/2023 ( http://www.chictr.org.cn , #ChiCTR2300074273).

Peng W ，Chu R ，Cui W ，Zhuang Y ，Chen W ，Han X ，Sun Z ，Zhang S ... -  《BMC MUSCULOSKELETAL DISORDERS》

[Unilateral biportal endoscopic posterior cervical foraminotomy for cervical radiculopathy].

Cheng W ，Zhang YJ ，Shao RX ，Zhu CY ，Wang D ，Liang JM ，Zhang W ，Pan H ... -  《-》

Short-term efficacy of unilateral biportal endoscopy technology in the treatment of cervical spondylotic radiculopathy.

Wen M ，Li X ，Lu X ，Chen T ，Qin R ... -  《-》