Comparison between unilateral biportal endoscopic and percutaneous posterior endoscopic cervical keyhole surgery for patients with cervical spondylotic radiculopathy

Study design The present study was retrospective in design. Objective The aim of this study was to compare the clinical outcomes of unilateral biportal endoscopic (UBE) and percutaneous posterior endoscopic cervical (PE) keyhole foraminotomy surgeries for patients with cervical spondylotic radiculopathy (CSR). Background data A total of 123 eligible patients with single-level cervical spine disc herniation treated with UBE or PE at our hospital between April 2020 and April 2023 were included. Patients were divided into two groups according to operation procedure. There were 28 men and 32 women in the UBE group with a mean age of 55.0 ± 9.0 years, while there were 29 men and 34 women in the PE group with a mean age of 57.3 ± 6.9 years. Method Data were collected from medical records. The study evaluated baseline characteristics, operation-related parameters (hospital stay, cost, and blood loss), clinical outcomes (Visual Analogue Scale VAS and Neck Disability Index NDI), and perioperative data (operation time, cost, surgery level, and pain level). MacNab criteria grade and complications were evaluated and compared. Result There were no significant differences in age, gender, pain level, operation level, preoperative VAS, NDI, and C2/7 Cobb angle between the two groups ( P 0.05). The UBE group showed significantly lower fluoroscopy and operation times. Moreover, patients in the UBE group achieved significantly better improvement in NDI, VAS-N (VAS of neck pain), and VAS-A (VAS of arm pain) at each follow-up visit compared with the PE group ( P 0.05). The excellent/good rates (MacNab criteria) in the UBE and PE groups were 96.67% (58) and 92.06% (58), respectively. In the PE group, three patients suffered from nerve root irritation and four sustained mild spinal epidural tears; in contrast, only one patient in the UBE group experienced nerve root irritation. Conclusion UBE may provide better clinical outcomes than PE in patients with CSR. More studies need to be conducted to further confirm the efficacy of UBE.