Arthroscopic-Assisted Uni-Portal Spinal Surgery Combined With Kirschner Wire Anchoring for Cervical Spondylotic...

Posterior endoscopic surgery has become a mainstream minimally invasive approach for the treatment of cervical spondylotic radiculopathy (CSR). Arthroscopic-assisted uni-portal spine surgery (AUSS), an emerging technique, has demonstrated favorable clinical outcomes in lumbar spine surgery; however, its feasibility and effectiveness in cervical spine surgery have not yet been reported. Accordingly, this technical note aimed to describe the surgical technique of AUSS combined with Kirschner wire anchoring for the treatment of CSR and to evaluate its preliminary clinical outcomes.

Fifteen consecutive CSR patients (9 males, 6 females) underwent AUSS combined with Kirschner wire anchoring between February and October 2024. Clinical outcomes were evaluated using the Visual Analogue Scale (VAS) for neck and arm pain, the Neck Disability Index (NDI), and the modified MacNab criteria. Pre- and postoperative pain and functional scores were compared using a paired t-test, with effect sizes (Cohen's d) and 95% confidence intervals (CIs) for mean differences calculated. Radiological parameters included osteotomy area and facet joint resection rate.

All procedures were successfully completed with a mean operative time of 97.7 ± 18.2 min and a mean incision length of 1.7 ± 0.2 cm. Postoperatively, VAS score for arm improved from 6.5 ± 0.9 to 2.8 ± 0.7 (p < 0.05), VAS score for neck from 4.3 ± 1.9 to 2.7 ± 1.0 (p < 0.05), and NDI from 54.3 ± 6.7 to 9.7 ± 2.4 (p < 0.05). The mean osteotomy area measured 98.6 ± 12.1 mm², with a facet joint removal rate of 27.6% ± 8.6%. At the 6-month follow-up, 86.7% (13/15) of patients achieved excellent/good outcomes. No serious surgery-related complications were observed.

The AUSS with Kirschner wire anchoring achieved significant pain relief and functional improvement in CSR, demonstrating feasibility and safety in the short term. However, larger cohorts and long-term studies are required to validate its efficacy.