Posterior Biportal Endoscopic Discectomy for the Treatment of Central Cervical Disc Herniation: Technical Note and Preliminary Results.

Abstract

To evaluate the preliminary outcomes and clinical efficacy of a novel posterior biportal endoscopic technique in the treatment of central cervical disc herniation (CCDH). A total of 11 patients with symptomatic CCDH who met the inclusion criteria underwent posterior biportal endoscopic discectomy between December 2021 and May 2023. The surgical procedure involved flavectomy, foraminotomy, pediculoplasty, and discectomy using 30° and 45° arthroscopes and specialized minimally invasive tools. Functional outcomes were assessed using the Japanese Orthopedic Association scoring system, Neck Disability Index, and visual analog scale for axial neck pain. Clinical efficacy was evaluated at the final follow-up using the modified Macnab criteria. All 11 patients successfully underwent posterior biportal endoscopic discectomy with a mean operative time of 82.7 ± 10.1 minutes and mean estimated blood loss of 31.8 ± 9.8 ml. The mean hospital stay was 5.2 ± 1.1 days, and the mean follow-up period was 13.8 ± 2.4 months. Significant improvements were observed in Neck Disability Index, Japanese Orthopedic Association, and visual analog scale scores. Clinical efficacy was rated as excellent in 3 patients, good in 6 patients, and fair in 2 patients according to the modified Macnab criteria. No cases of cervical instability or kyphosis were observed during postoperative follow-up. The novel posterior biportal endoscopic technique demonstrated significant clinical efficacy and safety in treating CCDH, with marked improvements in clinical outcomes, rapid postoperative recovery, and a low incidence of complications.