Comparison of clinical efficacy of posterior percutaneous endoscopic cervical discectomy versus unilateral biportal endoscopy key-hole techniques for cervical spondylotic radiculopathy: a retrospective study with 2 years

Journal of Orthopaedic Surgery and Research, 2025 · DOI: https://doi.org/10.1186/s13018-025-05617-2 · Published: February 14, 2025

Surgery Orthopedics

Simple Explanation

This study compares two minimally invasive surgical techniques, posterior percutaneous endoscopic cervical discectomy (PECD) and unilateral biportal endoscopy (UBE), for treating cervical spondylotic radiculopathy (CSR). CSR is a common condition caused by degenerative changes in the cervical spine that compress nerve roots. Both PECD and UBE are key-hole techniques aimed at reducing surgical trauma and achieving accurate decompression of the nerve roots, avoiding complications associated with traditional open surgeries like anterior cervical discectomy and fusion (ACDF). The study found that both techniques led to significant improvements in patients' pain and functional status, with similar success rates. While UBE had shorter operative times, it resulted in longer incisions compared to PECD.

Study Duration

From March 2019 to July 2022

Participants

70 patients with CSR (40 PECD, 30 UBE)

Evidence Level

Not specified

Key Findings

1
UBE group had shorter operative time compared to the PECD group (65.6 ± 17.6 vs. 85.1 ± 24.2 min, p < 0.001), but the former had longer incision length than the latter (2.4 ± 0.4 cm vs. 1.3 ± 0.4 cm, p < 0.001).
2
Both groups showed a significant reduction in the postoperative cSVA compared to preoperative measurements (PECD: p = 0.009; UBE: p = 0.010).
3
The excellent/good rates were 87.5% in the PECD group and 90.0% in the UBE group.

Research Summary

This retrospective study compared PECD and UBE for CSR treatment, finding both effective in improving VAS and NDI scores. The study included 70 patients, with 40 undergoing PECD and 30 undergoing UBE. UBE had shorter operative times but longer incisions compared to PECD. Both techniques demonstrated similar excellent/good outcome rates (87.5% for PECD and 90.0% for UBE) based on modified MacNab criteria. The study concludes that both PECD and UBE are viable options for CSR, offering minimal invasiveness and high safety profiles. UBE provides advantages like a wider field of view and flexible dual-channel operation.

Practical Implications

Surgical Technique Choice

Surgeons can consider both PECD and UBE as effective options for treating CSR, taking into account the potential for shorter operative times with UBE and smaller incisions with PECD.

Patient Selection

Patient selection should be based on individual clinical symptoms, radiographic findings, and surgeon experience, with PECD favored for lateral disc herniation and foraminal stenosis, and UBE for foraminal stenosis with or without osteophytes.

Transitional Treatment

UBE can serve as a transitional treatment before fusion surgery for patients without cervical instability or ligament ossification, supplementing conventional surgical deficiencies.

Study Limitations

1
The study is a retrospective analysis.
2
The sample size may be too small to detect significant differences in some outcomes.
3
The follow-up duration might be insufficient to observe long-term complications or recurrence.

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