OBJECTIVE: To investigate the clinical efficacy of posterior unilateral biportal endoscopic(UBE) cervical discectomy for cervical radiculopathy under general anesthesia. METHODS: A retrospective analysis of 35 patients with cervical disc herniation uderwent posterior UBE cervical discectomy under general anesthesia from March 2021 to March 2023 was performed, including 17 males and 18 females, with an average age of (56.00±7.79) years old ranging from 42 to 69 years old. The non-operative treatment time was 6 to 27 weeks with an average of(16.03±4.56) weeks. MRI showed lateral cervical disc herniation in 19 cases and foraminal cervical disc herniation in 8 cases. The pathological segments distribution was as follows L_4,5 in 5 cases, C_5,6 in 12 cases C_6,7 in 18 cases. CT/MRI was performed 1 to 3 d after surgery to evaluate the decompression, and the visual analogue scale(VAS), the Japanese Orthopedic Association(JOA) score, the stability of cervical spine surgery segment and the change of intervertebral height were recorded. RESULTS: All 35 patients successfully completed the operation, and the operation time was (55.88±5.02) min, the hospital stay after surgery (3.53±0.74) d. All 35 patients were followed up from 12 to 24 months with an average of (14.53±2.32) months. The VAS of preoperative, postoperative 1 day and 12 months were (7.000±0.875), (2.540±0.611), (2.143±0.772), respectively, the VAS at each time point before and after surgery were statistically significant(P<0.05). The JOA scores of preoperative, postoperative 1 day and 12 months were (11.660±0.533), (16.430±0.655), (16.540±0.611), respectively. The intervertebral height of the lesion segment at preoperative and 12 months was (6.206±0.493) mm and (6.147±0.497) mmm, respectively, and the difference was not statistically significant(P>0.05). None of the patients had cervical spine segment instability before or after surgery. According to the modified Macnab criteria, the clinical efficacy was evaluated at 12 months after operation, 32 cases were excellent, 2 cases were good, and 1 case was good. CONCLUSION UBE cervical discectomy is a minimally invasive, safe and effective surgical method for the treatment of single-segment cervical disc herniation, which may be an alternative to the treatment of cervical foraminal herniation, but due to the small sample size and short follow-up time, its long-term efficacy needs to be further observed.
Humans ; Middle Aged ; Male ; Female ; Adult ; Radiculopathy/surgery* ; Cervical Vertebrae/surgery* ; Aged ; Endoscopy/methods* ; Foraminotomy/methods* ; Retrospective Studies ; Intervertebral Disc Displacement/surgery*

This case report describes a new method of pain management intervention: percutaneous foraminotomy using the Claudicare system (Seawon Meditech, Korea). In this case, a 77-year-old Asian man visited the hospital with motor weakness in his left foot. He was diagnosed with L4–5 grade three foraminal stenosis using Magnetic Resonance Imaging on both sides. A left L4–5 foraminal decompression was performed using percutaneous foraminotomy. The patient revisited the hospital after 17 months because the same symptoms recurred in his right foot. We observed that the symptoms on the left foot had disappeared completely. We confirmed the lesion on the right side and the postoperative change on the left side on the magnetic resonance imaging (MRI) image. Both the pre- and postoperative MRI images were compared by measuring the dimensions of the foraminal area (28.12 mm² vs. 38.58 mm², repectively). T1W images showed signs of increased epidural soft tissue after percutaneous foraminotomy.
Aged ; Asian Continental Ancestry Group ; Constriction, Pathologic* ; Decompression ; Foot ; Foraminotomy* ; Humans ; Magnetic Resonance Imaging ; Methods ; Pain Management ; Spinal Stenosis ; Spine

STUDY DESIGN: Retrospective. PURPOSE: To analyze whether the cross-sectional area of the intervertebral foramen at the outermost edge of the resection site is associated with postoperative outcomes and whether our fluoroscopic method for determining the resection area is appropriate. OVERVIEW OF LITERATURE: There is no consensus on the criteria for determining an optimal resection area to obtain sufficient decompression while maintaining intervertebral stability in posterior percutaneous endoscopic cervical foraminotomy. Previous reports have recommended a facet resection rate (FRR) of ≤50%. Intervertebral foramen stenosis often extends to the exit zone. The cross-sectional area of the intervertebral foramen is occasionally small at the outermost edge of the resection site. No report has analyzed whether these aspects are associated with postoperative outcomes. METHODS: Lateral margins of the resection area were set at lateral borders of the vertebral body on frontal fluoroscopic view. Because the percutaneous endoscope has a small diameter, surrounding structures can easily be identified using frontal view fluoroscopy to determine the resection area. FRRs were calculated from postoperative computed tomography images. The smallest cross-sectional area of the intervertebral foramen around the lateral edge of the resection area (SALE) was measured and compared wit clinical outcomes. RESULTS: The mean FRR was 41.7% at C5–C6 and 48.9% at C6–C7. SALE was not correlated with clinical outcomes. CONCLUSIONS: Residual stenosis in the lateral portion of the intervertebral foramen is weakly associated with postoperative outcomes. Our process achieved adequate FRRs and favorable postoperative outcomes, suggesting that our criteria for determining the resection area are appropriate.
Commerce ; Consensus ; Constriction, Pathologic ; Decompression ; Endoscopes ; Fluoroscopy ; Foraminotomy* ; Methods ; Retrospective Studies

The technique we describe was developed for cervical foraminal stenosis for cases in which a keyhole foraminotomy would not be effective. Many cervical stenosis cases are so severe that keyhole foraminotomy is not successful. However, the technique outlined in this study provides adequate enlargement of an entire cervical foraminal diameter. This study reports on a novel foraminal expansion technique. Linear drilling was performed in the middle of the facet joint. A small bone graft was placed between the divided lateral masses after distraction. A lateral mass stabilization was performed with screws and rods following the expansion procedure. A cervical foramen was linearly drilled medially to laterally, then expanded with small bone grafts, and a lateral mass instrumentation was added with surgery. The patient was well after the surgery. The novel foraminal expansion is an effective surgical method for severe foraminal stenosis.
Constriction, Pathologic ; Foraminotomy ; Humans ; Methods ; Transplants ; Zygapophyseal Joint