JORT Journal

Abstract

Objectives: This study assessed the clinical outcomes of using the Unilateral Biportal Endoscopy(UBE) compared to the conventional anterior cervical decompression and fusion (ACDF) in treating patients with cervical radiculopathy. Patients and Methods: From February 2019 to November 2023, patients with single cervical radiculopathy were enrolled in this study. Patient’s age, sex, symptom side, operated level, operative time, postoperative hospital stay, return to work time, and complications were recorded. The Visual Analog Scale (VAS) for neck and arm pain, the Neck Disability Index (NDI) for functional status, to compare the cervical range of motion (ROM) and the modified MacNab criteria were used to quantify the postoperative outcomes. Results: 141 patients were initially enrolled in this study, while six were lost during the follow-up. The remaining 135 patients were divided into two groups. 94 patients underwent conventional ACDF, and the UBE procedure treated 41. There was no statistically significant difference between the two groups in age, sex, symptom side, and postoperative hospital stay. Operative time in the UBE group was slightly longer than in the ACDF group (135.17±36.37 VS 108.39±29.14 minutes, P＜0.05). Return to work time was significantly less in patients treated with UBE than those undergoing ACDF (32.76±10.97 VS 77.93±14.63 days, p < 0.05). The two groups had no significant differences in the VAS scores and the NDI. The patients in the UBE group obtained a better ROM than those in the ACDF group over time (p < 0.001). There was one severe complication in each group. In the UBE group, there was one case of spinal cord injury. In the ACDF group, one patient died due to laryngeal edema. Conclusion: UBE could significantly relieve pain, preserve ROM, and reduce complications. The majority of patients were satisfied with this technique. Thus, it is safe and effective to use this procedure to manage patients with cervical radiculopathy as an alternative to ACDF.

Keywords: Anterior cervical discectomy and fusion; Unilateral biportal endoscopy; Cervical radiculopathy; Spine surgery; Functional outcomes