Unilateral Biportal Endoscopic Laminectomy for Treating Cervical Stenosis: A Technical Note and Preliminary Results

Abstract

Objective: The objective of this study was to introduce a surgical technique for the percutaneous decompression of cervical stenosis (CS) using a unilateral biportal endoscopic approach and characterize its early clinical and radiographic results. Materials and Methods: Nineteen consecutive patients with CS who needed surgical intervention were recruited. All enrolled patients underwent unilateral biportal endoscopic laminectomy (UBEL). All patients were followed postoperatively for >1 year. The preoperative and final follow-up evaluations included the Japanese Orthopedic Association (JOA) score for neurological assessment, visual analogue scale (VAS) for axial pain and C2–C7 Cobb angle for cervical sagittal alignment. The postoperative complications were analyzed. Results: Thirteen males and six females were included in the analysis. The mean follow-up period was 16.3 ± 2.6 months. The mean operative time was 82.6 ± 18.4 min. Postoperative MRI and CT revealed ideal neural decompression of the treated segments in all patients. Preoperative VAS and JOA scores improved significantly after the surgery, and cervical lordosis was preserved on the postoperative images. Conclusions: UBEL was an effective surgical method for CS, which may also minimize iatrogenic damage to the posterior tension band (PTB) and help to maximize the preservation of the cervical lordosis.

Evolution, Current Trends, and Latest Advances of Endoscopic Spine Surgery

“…Some studies have demonstrated that UBE laminectomy may be considered an excellent surgical alternative to treat cervical stenosis without the development of iatrogenic kyphosis [ 93 ]. It represents an effective method with excellent neurological and radiological outcomes with less soft tissue invasion, which translates into dramatically less postoperative axial pain and maintains postoperative cervical lordosis [ 93 ].…”

“…Some studies have demonstrated that UBE laminectomy may be considered an excellent surgical alternative to treat cervical stenosis without the development of iatrogenic kyphosis [ 93 ]. It represents an effective method with excellent neurological and radiological outcomes with less soft tissue invasion, which translates into dramatically less postoperative axial pain and maintains postoperative cervical lordosis [ 93 ]. Wang et al concluded in their study that UBE and Percutaneous posterior endoscopic discectomy were both safe and effective in the treatment of cervical spondylotic radiculopathy and were characterized by minimal trauma, no adverse impact on cervical stability, and few complications [ 94 ].…”

Evolution, Current Trends and Latest Advances of Endoscopic Spine Surgery: A Narrative Review

“…It represents an effective method with excellent neurological and radiological outcomes with less soft tissue invasion, which translates into dramatically less postoperative axial pain and maintained postoperative cervical lordosis (93). Wang et al concluded in their study that UBE and PE (percutaneous posterior endoscopic discectomy) were both safe and effective in the treatment of cervical spondylotic radiculopathy and were characterized by minimal trauma, no adverse impact on cervical stability and few complications (94). It is safe to say that cervical endoscopic surgeries have evolved and are no longer limited to dealing with just single level disc disease.…”

Comparison of Cervical Biportal Endoscopic Spine Surgery and Anterior Cervical Discectomy and Fusion in Patients with Symptomatic Cervical Disc Herniation

“…A well-trained surgeon then uses specialized instruments to remove the bony structure or herniated disc without affecting the surrounding healthy tissues. Several reports on the technical notes and clinical outcomes of C-BESS have recently been published [ 13 , 14 ].…”