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》

Clinical efficacy and learning curve of percutaneous endoscopic cervical discectomy for symptomatic cervical spondylotic radiculopathy.

This study aimed to evaluate the clinical efficacy and learning curve of percutaneous endoscopic cervical discectomy (PECD) in treating patients with symptomatic cervical spondylotic radiculopathy (CSR). A total of 105 patients with single-segment symptomatic CSR treated between January 2020 and January 2022 were retrospectively analyzed and divided into PECD and ACDF groups based on the surgical approach. Patient demographics, operation time, estimated intraoperative blood loss, complications, postoperative hospital stay, total hospitalization cost, neck dysfunction index (NDI), arm and neck visual analog scale (VAS) scores were compared and analyzed. The learning curve of the PECD group was assessed using cumulative sum (CUSUM) analysis. There was no statistically significant difference in baseline data between the two groups (P > 0.05). The PECD group had shorter operative time, smaller incision length, less estimated intraoperative bleeding, lower total hospitalization costs, and shorter postoperative hospital stays compared to the ACDF group (P < 0.05). Postoperative NDI, arm VAS, and neck VAS scores improved significantly in both groups compared to preoperative values (P < 0.05). However, no significant difference was found between the two groups during the same period (P > 0.05). There were also no significant differences between the PECD and ACDF groups in the number of intraoperative fluoroscopies, complications, or surgical success rates (P > 0.05). As more cases accumulated, a trend toward shorter operative times was observed in the PECD group. When grouped according to the learning curve, with the 23rd case as the cutoff point, there was no significant difference in clinical outcomes between the learning phase and proficient phase groups (P > 0.05). PECD is a safe and effective procedure for treating single-segment CSR, offering clinical outcomes comparable to ACDF. PECD has a notable learning curve, requiring beginners to perform 23 cases to reach proficiency. However, longer operative times do not negatively impact preclinical outcomes. Retrospectively registered.

Sun X ，Zhan L ，Tang Z ，Shen M ，Ma H ，Tan J ... -  《-》

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》

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 ... -  《-》

[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 ... -  《-》