Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Aug 18, 2025; 16(8): 109904
Published online Aug 18, 2025. doi: 10.5312/wjo.v16.i8.109904
Novel endoscopic hybrid technique in the treatment of cervical spondylotic radiculopathy
Mei-Jun Yan, Bei-Ting Zhang, Guo-Ke Tang, Yan-Bin Liu, Wei-Bo Liao, Song Guo, Qiang Fu
Mei-Jun Yan, Bei-Ting Zhang, Guo-Ke Tang, Yan-Bin Liu, Song Guo, Qiang Fu, Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
Wei-Bo Liao, Department of Orthopedics, Mangshi People's Hospital, Dehong State 678400, Yunnan Province, China
Co-first authors: Mei-Jun Yan and Bei-Ting Zhang.
Co-corresponding authors: Song Guo and Qiang Fu.
Author contributions: Yan MJ and Zhang BT designed the research study; Yan MJ, Tang GK, and Liu YB performed the research; Zhang BT, Guo S, and Liao WB collected the data; Yan MJ, Zhang BT, Guo S, and Liu YB analyzed the data and wrote the manuscript; Fu Q performed all the surgeries in the article; both Guo S and Fu Q have played important and indispensable roles in the experimental design, data interpretation and manuscript preparation as the co-corresponding authors; all authors have read and approve the final manuscript.
Supported by the Provincial Natural Science Foundation of Gansu, No. 24JRRF008; Science and Technology Research Project of Songjiang District, No. 2024SJKJGG105; National Natural Science Foundation of China, No. 82202694; and Clinical Research Innovation Plan of Shanghai General Hospital, No. CTCCR-2021C10.
Institutional review board statement: This study was approved by the Ethics Committee of Shanghai General Hospital (approval No. 2019SQ378), and the study was conducted in accordance with the Declaration of Helsinki. All participants provided informed consent to participate.
Informed consent statement: All participants provided informed consent for publication.
Conflict-of-interest statement: The authors declare that there are no competing interests.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qiang Fu, MD, PhD, Director, Professor, Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 85 Wujin Road, Shanghai 200080, China. 561774230@qq.com
Received: May 26, 2025
Revised: June 16, 2025
Accepted: July 15, 2025
Published online: August 18, 2025
Processing time: 75 Days and 12.8 Hours
Abstract
BACKGROUND

This is a retrospective study on endoscopic treatment of cervical spinal radiculopathy (CSR) conducted at a single academic institution. Conventional full-spine endoscopy is performed in a single portal which has certain limitations of high technical requirements, steep learning curve, and narrow indications. Although unilateral biportal endoscopy (UBE) technique has a gentle learning curve and is gradually applied to treat CSR, all procedures were performed in the uniportal working channel that potentially increase the surgical risk and time in the treatment of complex cases. It is worthy to delve novel technique for more working channels in the treatment of complex CSR.

AIM

To propose a hybrid technique (HT) that utilizes spine endoscopy in UBE to treatment of CSR.

METHODS

A total of 81 patients with single-segment CSR who underwent uniportal endoscopic surgery (UES), UBE, or HT at a single institution between September 2019 and August 2021 were retrospectively studied. Perioperative patient data were compared between the groups. The pre-operative and post-operative images were compared to confirm adequate decompression of the nerve root canal. Patients' visual analogue scale (VAS) scores and neck disability index (NDI) were recorded before surgery, and three days, three months and six months after surgery.

RESULTS

The UBE and HT groups had a significantly shorter operation duration than the UES group. Data for bleeding and length of hospital stay were significantly higher in the UBE group than in the UES and HT groups. The hospitalization cost was lowest in the UES group and highest in the HT group. Soft tissue edema reaction bands on post-operative day 3 were larger in the UBE and HT groups than in the UES group. Post-operative VAS and NDI scores were significantly lower in all three groups than the pre-operative levels. On post-operative day 3, the VAS score for neck pain was significantly higher in the UBE and HT groups than that in the UES group. However, there were no significant differences in the VAS scores for arm pain or NDI between the three groups. The post-operative 3-month and 6-month neck pain VAS, arm pain VAS, NDI, and modified Macnab success rates did not differ statistically between the three groups.

CONCLUSION

The HT for CSR treatment has the advantage of double working channels to facilitate decompression and hemostasis, improving the surgical efficiency and clinical outcomes of CSR.

Keywords: Cervical spondylotic radiculopathy; Minimally invasive spinal surgery; Unilateral biportal endoscopy; Full-spine endoscopy

Core Tip: This study proposed a hybrid technique (HT) that utilizes spine endoscopy in unilateral biportal endoscopy to obtain another working channel to treat the cervical spondylotic radiculopathy. The HT has the advantage of double working channels to facilitate decompression and hemostasis, improving the surgical efficiency and clinical outcomes.