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ORIGINAL RESEARCH article

Front. Surg.

Sec. Orthopedic Surgery

Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1687974

This article is part of the Research TopicEndoscopy, Navigation, Robotics, Current Trends and Newer Technologies in the Management of Spinal Disorders. Towards a Paradigm Change in the Clinical Practice.View all 5 articles

Unilateral Biportal Endoscopic with Modified Arcocristectomy for Pinching Cervical Spondylotic Myelopathy: Surgical Technique and Early Experiences

Provisionally accepted
Xiaopeng  LiXiaopeng Li1,2,3Haochen  HuHaochen Hu2Penghe  LiPenghe Li2Bing  ChenBing Chen2Feng  LiFeng Li3Chao  ChenChao Chen1Baoshan  XuBaoshan Xu1Xinlong  MaXinlong Ma1Xigao  ChengXigao Cheng4Qiang  YangQiang Yang1,2*
  • 1Tianjin Hospital, Tianjin, China
  • 2Tianjin Medical University, Tianjin, China
  • 3Weifang People's Hospital, Weifang, China
  • 4Nanchang University Second Affiliated Hospital, Nanchang, China

The final, formatted version of the article will be published soon.

Objectives Introduce the surgical technique and early clinical efficacy of the modified arcocristectomy for treating pinching cervical spondylotic myelopathy using unilateral approach for bilateral decompression under cervical UBE surgery. Methods This study enrolled nine patients with pinching cervical spondylotic myelopathy who underwent modified Arcocristectomy with UBE for unilateral approach and bilateral decompression at our medical center between December 2023 and November 2024. Patients' demographic data, imaging findings, and perioperative data were collected. Neurological recovery was assessed using the JOA score and the NDI. Imaging parameters, including cervical lordosis, segmental cervical angle at the surgical level, and maximum sagittal diameter of the spinal canal, were measured preoperatively, on the first postoperative day, and at the final follow-up. The safety and efficacy of the surgery were evaluated by comparing and analyzing these indicators. Results The study included six men and three women. The mean preoperative symptom duration was 14.13±16.57 months, and the mean follow-up duration was 14.00±5.13 months. The mean preoperative JOA score was 9.25±3.28, which improved to 12.00±3.21 on the first postoperative day, representing a mean improvement rate of 39.93±15.07%. At the final follow-up, the mean JOA score was 14.38±2.13, with a mean improvement rate of 69.85±12.74%. The mean NDI score was 42.25±15.00%preoperatively and decreased to 15.50 ±5.90% at the final follow-up. Imaging results showed that the mean preoperative cervical lordosis was 19.04±8.18°, which decreased to 4.91±5.59° postoperatively and returned to 19.31±7.82° at the final follow-up. The mean preoperative segmental cervical angle at the surgical level was 6.90±3.82°, which decreased to 1.85±2.08° postoperatively and returned to 7.05±3.36° at the final follow-up. The mean preoperative maximum sagittal diameter of the spinal canal at the surgical level was 5.71±2.03 mm, which increased to 11.98±1.91 mm postoperatively. Conclusion The innovation of the modified Arcocristectomy surgery under cervical UBE for treating pinching cervical spondylotic myelopathy lies in the extended resection of the posterior-superior margin of the lamina. This modification effectively alleviates spinal cord compression caused by the "pinching effect" during cervical extension. Short-term follow-up results demonstrate significant clinical improvements, offering a new minimally invasive treatment option for this condition.

Keywords: UBE, Modified Arcocristectomy, Pinching Cervical spondylotic myelopathy, Surgical technique, early experiences

Received: 18 Aug 2025; Accepted: 20 Oct 2025.

Copyright: © 2025 Li, Hu, Li, Chen, Li, Chen, Xu, Ma, Cheng and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Qiang Yang, yangqiang1980@tju.edu.cn

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