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December 16, 2025Operative Neurosurgery

Rediscovering Posterior Cervical Foraminotomy/Diskectomy With the Endoscope: A Favorable Cost Comparison with the Traditional Treatment of a Cervical Radiculopathy

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Authors

CLCampbell LilesHCHani ChanbourALAlexander T. Lyons

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Overview

Retrospective cohort study reveals lower surgical costs and shorter stays with endoscopic foraminotomy in cervical radiculopathy, highlighting a cost-efficient motion-preserving option.

Key Points

  • To compare the total surgical care costs and perioperative outcomes between full-endoscopic and open posterior cervical foraminotomy/diskectomy in patients with isolated unilateral cervical radiculopathy.
  • Conducted a single-center, retrospective cohort study of patients treated between 2016 and 2023 (N=30; 15 open, 15 full-endoscopic posterior cervical foraminotomy/diskectomy [FEPCF]).
  • Calculated initial surgical costs adjusted to 2023 US dollars and performed multivariable, sensitivity, and break-even analyses.
  • Total surgical cost (mean ± 95% CI) was 41.5% higher for open surgery than endoscopic surgery ($14,231 ± $1,297 vs $10,057 ± $755, P < .001), driven by open procedure type (β = $3,386, P = .001) and hospital stay duration (β = $1,768/day, P = .008).
  • Length of stay was significantly longer in the open cohort (0.9 ± 0.8 vs 0.1 ± 0.2 days, P < .001), whereas operative duration was similar (158.8 ± 49.9 vs 140.3 ± 28.2 minutes, P = .224).
  • Both cohorts had equivalent 6-week neurological improvement with no significant differences in complications, reoperations, or readmissions, and zero endoscopic patients required postoperative narcotics.

Cite This Study

Liles et al. (2025) studied this question.

synapsesocial.com/papers/6a73c1fab87a25d16efb78a2https://doi.org/10.1227/ons.0000000000001861
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Revisiting the Posterior Approach for Cervical Radiculopathy Utilizing Endoscopic Techniques: A Favorable Short-Term Outcome and Cost Comparison With Anterior Cervical Discectomy and Fusion2024 · 8 citations
  2. 2Fully Endoscopic Posterior Cervical Foraminotomy: A Systematic Review of Clinical and Surgical Outcomes2026
  3. 3Full Endoscopic Posterior Cervical Foraminotomy and Discectomy: Technical Note and Institutional Experience2025
  4. 4Open Versus Endoscopic Approach for Thoracic Disk Herniations: Equivalent Short-Term Outcomes With Significantly Different Costs2024 · 2 citations
  5. 5Biportal Endoscopic Posterior Cervical Foraminotomy2026