Posterior Cervical Decompression in Patients with Cervical Disc Herniation and Cervical Canal Stenosis Using Unilateral Biportal Endoscopy

Introduction: To describe the surgical technique of posterior percutaneous unilateral bi-portal endoscopic (UBE) approach and to evaluate the outcome for patients with lateral/foraminal cervical disc herniations and lateral cervical canal stenosis with radiculopathy and myelopathy respectively.

Methods: The study included 20 patients with lateral cervical disc prolapse and lateral cervical canal stenosis who were operated on with posterior percutaneous endoscopic cervical discectomy with a UBE approach. The outcome was assessed using questionnaires, which included the Neck Disability Index (NDI), Visual Analogue Scale (VAS), and Modified Japanese Orthopedic Association (mJOA) Score. This information was obtained preoperatively and again at 3, 6, and 12 months postoperatively and at the last follow-up.

Results: There were 12 females and 8 males. The mean follow-up duration was 1.2 years. 15 patients had radicular symptoms and 5 had myelopathy. Postoperatively all 15 patients showed improvement in their radicular symptoms. The average VAS improved from a preoperative score of 6.6 to 3.1 in the immediate postoperative period, 2.6 at 6 months postoperative, and 2.25 at 12 months. The average NDI improved from a preoperative value of 27.8 (56.6%) to 8.2 (16.4%) at 12 months. Even all 5 patients with myelopathy showed significant improvement in their symptoms postoperatively. The mean postoperative mJOA score of 15.2 for cervical myelopathy was statistically significantly improved compared with the preoperative JOA score of 12.2.

Conclusion : The posterior percutaneous endoscopic cervical discectomy with a UBE approach is a good alternative surgical technique for lateral or foraminal cervical disc herniations and lateral cervical canal stenosis and preserves the motion at the disc.