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

Background: Unilateral biportal endoscopy (UBE) is a minimally invasive approach to treat cervical spondylotic radiculopathy (CSR), which is a common condition caused secondary to disc herniation, disc degeneration, uncal osteophytes, and other conditions manifesting as neuropathic radicular pain. Anterior cervical discectomy and fusion (ACDF) is the gold standard surgical technique for treating CSR. However, it has several disadvantages, including loss of mobile segment, adjacent segment degeneration (ASD), implant-and approach-related complications, and high hospitalization costs. Objective: The current study aimed to evaluate the safety and efficacy of UBE decompression for CSR. Methods: After obtaining IRB approval, a single-center retrospective study was undertaken. Included patients underwent UBE decompression for CSR with a minimum of 6 months of follow-up. Patient demographics, perioperative data, and length of hospital stay were reviewed. Clinical outcomes were assessed using VAS scores for neck and arm pain, and NDI scores were measure preoperatively and at 1 and 6 months after UBE decompression. A repeated analysis of variance test was performed to measure the difference between VAS and NDI scores. Results: Twenty patients (M: 15, F: 5) with a mean age of 56.7 +/- 10.2 years were included. The mean follow-up period was 8.4 +/- 1.8 months. The mean surgical time was 64.3 +/- 10.6 minutes. The average length of hospital stay was 1 day. At the final follow-up, the mean VAS for arm pain improved from 6.4 +/- 0.7 to 0.6 +/- 0.5 (92% improvement) and the mean VAS for neck pain improved from 3.3 +/- 0.4 to 2.0 +/- 0.2 (40% improvement). NDI score improved from 23.2 +/- 1.95 to 5.7 +/- 0.6 at the final follow-up (75% improvement). There were no complications. Conclusion: UBE is a safe and effective surgical treatment option for patients with CSR with excellent clinical outcomes. Clinical Relevance: Clinical relevance of this case series study is to demonstrate the safety and efficacy of the novel unilateral biportal endoscopic decompression of cervical spondylotic radiculopathy and its short term clinical outcomes. Level of Evidence: 4.