Research ArticleEndoscopic Minimally Invasive Surgery

Clinical Outcomes Following Treatment of Cervical Spondylotic Radiculopathy With Cervical Posterior Decompression Using Unilateral Biportal Endoscopic Technique: A Single Center Retrospective Series of 20 Patients

Keyur K. Akbari, Teo Hong Lee Terry, Umesh Kanade and John Choi
International Journal of Spine Surgery November 2024, 8690; DOI: https://doi.org/10.14444/8690

Article Figures & Data

Figures

  • Figure 1
    Figure 1

    Patient prone on Jackson table with Gillespie pillow support to reduce abdominal pressure.

  • Figure 2
    Figure 2

    (a) Showing two 18 gauge spinal needles inserted on midpoint of C4 and C5 lateral masses. (b and c) Showing AP and lateral fluoroscopic images, respectively, of needle placement.

  • Figure 3
    Figure 3

    (a) V-point which is the junction of superior and inferior lamina with the medial aspect of facet joint. (b) Area marked is the extent of partial laminectomy-facetectomy.

  • Figure 4
    Figure 4

    Hook-tipped radiofrequency probe to coagulate epidural vessels.

  • Figure 5
    Figure 5

    (a) Scope cannula sheath safely retracting nerve root to expose the disc. (b) Scope cannula sheath.

  • Figure 6
    Figure 6

    T2-weighted magnetic resonance images with sagittal, left oblique, and axial views showing C6–C7 left-sided paracentral disc herniation compressing the left C7 nerve root. (a and b) Spinal needle placement and level marking. (c) Identifying the V point and drilling the C6 inferior lamina and C7 superior lamina along with C6–C7 facet joint till the bone is like an eggshell. (d) The ligamentum flavum is exposed and epidural vessels coagulated with a hook-tipped radiofrequency probe. (e) The C7 nerve root is exposed. (f) Scope cannula sheath retracting the C7 nerve root to expose the disc. (g and h) Disc fragment removed and C7 nerve root decompressed.

Tables

  • Table 1

    Demographic data of patients (n = 20) undergoing unilateral biportal endoscopic decompression for cervical spondylotic radiculopathy.

    DemographicValue
    Age, y, mean ± SD56.7 ± 10.2
    Sex, n, male/female15/5
    Preoperative duration of symptoms, mo, mean ± SD4.6 ± 2.3
    Follow-up, mo, mean ± SD8.4 ± 1.8
  • Table 2

    Pathology causing cervical nerve root compression.

    Cause n
    Disc herniation14
    Disc osteophyte complex4
    Facet hypertrophy2
  • Table 3

    Operative and perioperative data.

    VariableValue
    Level, n
     C1–C20
     C2–C31
     C3–C41
     C4–C52
     C5–C67
     C6–C78
     C7–T11
    Surgical time, min, mean ± SD64.3 ± 10.6
    Complications, n 0
    Length of stay, d, mean1
  • Table 4

    Clinical outcome measures: VAS score for arm and neck pain and NDI score.

    Outcome MeasurePreoperative1 mo Postoperatively6 mo PostoperativelyImprovement at 6 mo P
    VAS arm pain6.4 ± 0.71.3 ± 0.5 0.6 ± 0.5 92%0.001
    VAS neck pain3.3 ± 0.42.5 ± 0.2 2.0 ± 0.2 40%0.001
    NDI23.2 ± 1.9511.5±2.75.7 ± 0.675%0.001

    • Abbreviations: NDI, neck disability index; VAS, visual analog scale.

    • Note: VAS and NDI scores are provided as mean ± SD.

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Clinical Outcomes Following Treatment of Cervical Spondylotic Radiculopathy With Cervical Posterior Decompression Using Unilateral Biportal Endoscopic Technique: A Single Center Retrospective Series of 20 Patients
Keyur K. Akbari, Teo Hong Lee Terry, Umesh Kanade, John Choi
International Journal of Spine Surgery Nov 2024, 8690; DOI: 10.14444/8690
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