Unilateral biportal endoscopic foraminotomy and diskectomy combined with piezosurgery for treating cervical spondylotic radiculopathy with neuropathic radicular pain

Zhang, Peng; Jin, Yanghui; Zhu, Bin; Zheng, Mingming; Ying, Xiaozhang; Zheng, Qi

doi:10.3389/fneur.2023.1100641

Cited by 3 publications

(1 citation statement)

References 23 publications

(25 reference statements)

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“…CSR typically manifests as radicular pain and is usually managed conservatively [ 22 ]. In cases in which conservative management fails, surgical intervention can be required to alleviate symptoms by relieving compression [ 23 ]. MRI scans with a slice thickness of only 3 to 5 mm often fail to clearly demonstrate the morphology of nerve roots, leading to ambiguous or missed diagnoses of CSR [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Safety and Efficacy of Preoperative Coronal MRI-Guided Minimally Invasive Surgery for Cervical Spondylotic Radiculopathy

Liu,

Wu,

Yuan

et al. 2023

Med Sci Monit

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Background Key-hole surgery is a minimally invasive technique that has shown promise in various surgical procedures. This study aimed to assess the clinical effectiveness of preoperative coronal MRI-assisted key-hole surgery for the treatment of patients with cervical spondylotic radiculopathy (CSR). Material/Methods A total of 30 patients diagnosed with CSR and undergoing key-hole surgery with CMRI assistance were included in the study. Various parameters, including surgical segments, incision length, disease duration, operative time, intraoperative fluoroscopy times, intraoperative blood loss, complications, and length of hospitalization, were recorded. Precise measurements of Cobb angles and intervertebral space height were taken before and after the surgical procedure. Surgical outcomes were evaluated using modified Macnab criteria, visual analogue scale (VAS), Japanese Orthopaedic Association Scores (JOA), and neck disability index (NDI). Results The average duration of disease was 6.47±3.29 months, with an average incision length of 1.94±0.15 cm and operative time of 57.83±4.34 minutes. The average intraoperative blood loss was 33.70±9.28 ml, with an average of 3.50±0.73 intraoperative fluoroscopies. The average duration of hospitalization was 4.10±1.27 days. Preoperative and postoperative measurements showed no statistically significant difference in C2–C7 Cobb angles and intervertebral space height. However, there were significant improvements in postoperative VAS, NDI, and JOA scores compared to preoperative scores. The surgical effectiveness rate was 100%, with a high rate of good and excellent outcomes. Conclusions The findings of this study suggest that preoperative CMRI-assisted key-hole surgery for single-segment CSR is a safe and effective treatment option with low complication rates. The clinical benefits include high security and good outcomes. Further research and larger studies are warranted to validate these findings.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Safety and Efficacy of Preoperative Coronal MRI-Guided Minimally Invasive Surgery for Cervical Spondylotic Radiculopathy

Liu,

Wu,

Yuan

et al. 2023

Med Sci Monit

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Clinical Outcomes and Complications of Unilateral Biportal Endoscopic Posterior Cervical Foraminotomy: A Systematic Review and Meta-Analysis With a Comparison to Full-Endoscopic Posterior Cervical Foraminotomy

Lee,

Seo,

Jeong

et al. 2024

Neurospine

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Objective: The unilateral biportal endoscopic posterior cervical foraminotomy (UBE-PCF) has been recently adopted for unilateral radiating arm pain due to cervical herniated intervertebral disc or foraminal stenosis. We systematically meta-analyzed clinical outcomes and complications of the UBE-PCF and compared them with those of full-endoscopic PCF (FE-PCF).Methods: We systematically searched the PubMed, Embase, and Web of Science until February 29, 2024. Clinical outcomes and complications of the UBE-PCF and FE-PCF were collected and analyzed using the fixed-effect or random-effects model. Clinical outcomes of the UBE-PCF were compared with minimal clinically important difference (MCID) following PCF to evaluate the efficacy of UBE-PCF.Results: Ten studies were included in the meta-analysis. In the random-effects meta-analysis, the Neck Disability Index (NDI), visual analogue scale (VAS) neck, and VAS arm were significantly decreased after the UBE-PCF (p<0.001). The improvement of NDI, VAS neck, and VAS arm were significantly higher than MCID (p<0.05). The improvement of NDI, VAS neck, and VAS arm were not significantly different between the UBE-PCF and FE-PCF (p>0.05). Overall incidence of complications of the UBE-PCF was 6.2% (24 of 390). The most common complication was dura tear (2.1%, 8 of 390). The incidence in overall complications was not significantly different between the UBE-PCF and FE-PCF (p=0.813).Conclusion: We found that the UBE-PCF significantly improved clinical outcomes. Regarding clinical outcomes and complications, the UBE-PCF and FE-PCF were not significantly different. Therefore, the UBE-PCF would be an advantageous surgical option comparable to FE-PCF for unilateral radiating arm pain.

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Unilateral biportal endoscopic spine surgery: a meta-analysis unveiling the learning curve and clinical benefits

Liu,

Chen,

Chen

et al. 2024

Front. Surg.

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ObjectiveTo provide insights into the learning curve of unilateral biportal endoscopic (UBE) spine surgery by synthesizing available evidence on critical points and associated clinical outcomes.MethodsA comprehensive literature search was conducted across multiple databases, yielding a pool of relevant studies. Inclusion criteria encompassed studies reporting on UBE learning curves and quantitative data related to clinical outcomes (operative time, hospital stay, and complications).ResultsA total of five studies were included in the analysis, providing six datasets to elucidate the UBE learning curve. Three of the five studies analyzed learning curves using the Cumulative Sum method and identified cutoff points. One study plotted learning curves and determined cutoff points based on surgical time analysis, while the remaining one study (providing two datasets) plotted learning curves using the phased analysis method. The mean value of the cutoff point in terms of the number of cases required to reach proficiency in time to surgery was calculated at 37.5 cases, with a range spanning from 14 to 58 cases. Notably, there was a statistically significant difference in time to surgery between the late group and the early group, with the late group demonstrating a significantly reduced time to surgery (P < 0.0001). Additionally, the determined cutoff points exhibited significant variations when applied to patient outcome parameters, including postoperative hospitalization, postoperative drainage, and surgical complications (P < 0.05).ConclusionWhile the analysis indicates that UBE surgery's learning curve is associated with surgical time, the limited focus on this metric and potential discrepancies in cutoff point determination highlight the need for a more comprehensive understanding.

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Unilateral biportal endoscopic foraminotomy and diskectomy combined with piezosurgery for treating cervical spondylotic radiculopathy with neuropathic radicular pain

Cited by 3 publications

References 23 publications

Evaluation of Safety and Efficacy of Preoperative Coronal MRI-Guided Minimally Invasive Surgery for Cervical Spondylotic Radiculopathy

Evaluation of Safety and Efficacy of Preoperative Coronal MRI-Guided Minimally Invasive Surgery for Cervical Spondylotic Radiculopathy

Clinical Outcomes and Complications of Unilateral Biportal Endoscopic Posterior Cervical Foraminotomy: A Systematic Review and Meta-Analysis With a Comparison to Full-Endoscopic Posterior Cervical Foraminotomy

Unilateral biportal endoscopic spine surgery: a meta-analysis unveiling the learning curve and clinical benefits

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