Novel Cervical Endoscopic Unilateral Laminoforaminotomy for Bilateral Decompression in Cervical Spondylosis Myeloradiculopathy: A Technical Note and Clinical Results

Background: This study investigates the efficacy of the Cervical Endoscopic Unilateral Laminoforaminotomy for Bilateral Decompression (CE-ULFBD) technique in treating cervical myeloradiculopathy, primarily caused by degenerative spondylosis. Traditionally managed through multisegmental anterior cervical discectomy and fusion (ACDF) or laminoplasty combined with foraminotomy, this condition has recently experienced a promising shift towards minimally invasive approaches, particularly endoscopic spinal decompression. While empirical evidence is still emerging, these techniques show potential for effective treatment. Method: The objective was to evaluate the outcomes of CE-ULFBD in achieving single or multilevel bilateral foraminal and central decompression, emphasizing the reduction of injury to posterior cervical muscles and the associated postoperative neck soreness common in conventional procedures. This paper delineates the surgical procedures involved in CE-ULFBD and presents the clinical outcomes of nine patients diagnosed with myeloradiculopathy due to severe cervical stenosis. Result: Assessments were conducted using the Visual Analogue Scale (VAS) for neck and arm pain and the Modified Japanese Orthopaedic Association scale (mJOA) for the activity measurement of daily living. Results indicated a considerable decrease in pain levels according to the VAS, coupled with significant improvements in functional capacities as measured by the mJOA scale. Additionally, no major postoperative complications were noted during the follow-up period. Conclusion: The study concludes that CE-ULFBD is a safe and effective approach for the treatment of cervical myeloradiculopathy resulting from severe cervical stenosis, offering a viable and less invasive alternative to traditional decompressive surgeries.

Clinical efficacy of posterior endoscopic cervical modified trench technique in the treatment of cervical spondylotic myelopathy: A retrospective study

To investigate the clinical efficacy of the posterior endoscopic cervical modified trench technique in the treatment of cervical spondylotic myelopathy (CSM). This retrospective study included 9 patients with single-segment CSM, who were treated with posterior endoscopic cervical modified trench technique. Related clinical data, the visual analog scale, Japanese Orthopedic Association (JOA) ratings, JOA improvement rate, the minimum sagittal diameter of the spinal canal, and surgical complications were recorded. There were 5 men and 4 females, with an average age of 60.44 ± 16.49 years. Without any significant side effects like paralysis, vascular damage, or cerebrospinal fluid leaking, all surgeries were successfully completed. One year's worth of follow-up with patients lasted for 8.56 ± 3.68 months. When compared to before surgery, the postoperative visual analog scale ratings, JOA scores, and minimum sagittal diameter of the spinal canal value all showed a substantial improvement (P < .01). At the most recent follow-up, 2 patients had a JOA improvement rate of >75%, 6 patients had a JOA improvement rate of 74 to 50%, 1 patient had a JOA improvement rate of 49 to 25%, and none had a JOA improvement rate of <25%. The JOA improvement rate was above 90% for overall excellent and good ratings. In our study, the ventral epidural space may be maneuvered more easily and instrument-induced nerve discomfort is decreased when using the posterior endoscopic cervical modified trench approach with posterior endoscopy. The short-term clinical effect of the posterior endoscopic cervical modified trench technique for CSM is satisfactory.