CLINICAL ANALYSIS OF MINIMALLY INVASIVE POSTERIOR PERCUTANEOUS ENDOSCOPIC CERVICAL KEYHOLE FORAMINOTOMY FOR NEURAL DECOMPRESSION IN CERVICAL SPONDYLOTIC RADICULOPATHY

Rishat Ibtisham, Jannatul Ferdhous, Ayesha Fariha, Maria Akter, Tahasin Hossain

ABSTRACT

Object: Investigating the therapeutic utility and safety of posterior percutaneous endoscopic cervical keyhole foraminotomy (PPECF) in the treatment of cervical spondylotic radiculopathy. Method: 40 patients with cervical spondylotic radiculopathy (CSR) who received PPECF treatment at Yangzhou University's Affiliated Hospital between January 2020 and January 2024 were the subject of a retrospective review that assessed operative time, postoperative hospital stay, complications, and recurrence. Prior to surgery, just after surgery, and at the final follow-up, the neck disability index (NDI), visual analog score (VAS), and Japanese orthopaedic association scores (JOA) were compared. Using a modified MacNab grading system, the clinical efficacy was evaluated. Result: All 40 patients underwent successful surgery, and substantial statistical differences were observed between the preoperative and postoperative VAS, JOA, and NDI scores. At the last follow-up, one patient had postoperative painful root palsy, but had fully recovered. Thirty-two patients had significant instant relief in their postoperative symptoms. Following surgery, one patient's arm pain and numbness did not significantly improve; nonetheless, the problem was manageable, so further therapy was discontinued. At 97.5%, the modified MacNab grading was considered excellent and good. Neither the perioperative nor follow-up periods saw any complications, such as dural tears, infections, or postoperative hematomas, and none of the patients needed a second minimally invasive or open surgery to treat dissent. Conclusion: Comparatively speaking to other posterior surgeries, PPECF treatment for CSR can produce satisfactory clinical outcomes while avoiding cervical spine fusion and maintaining cervical spine movement function with minimal damage to achieve the impact of nerve root decompression. For the treatment of CSR, PPECF is a minimally invasive, safe, and successful surgical technique.

Keywords: Cervical spondylotic radiculopathy; keyhole surgery; posterior percutaneous endoscopic cervical surgery; minimally invasive spinal surgery; clinical efficacy.