UNILATERAL BIPORTAL ENDOSCOPIC SURGERY FOR CERVICAL RADICULOPATHY AND MYELOPATHY: CURRENT EVIDENCE, MOTION- PRESERVING DECOMPRESSION, AND THE PROPOSED UBE-CERV FRAMEWORK

Аннотация

Background. Unilateral biportal endoscopic cervical surgery has expanded from posterior cervical foraminotomy for unilateral radiculopathy to selected decompressive procedures for cervical myelopathy. Its independent viewing and working portals permit magnified visualization, bimanual instrumentation, targeted bone removal, and motion-preserving neural decompression. 
Materials and methods. Randomized trials, comparative cohorts, systematic reviews, meta- analyses, technical reports, and multilevel decompression studies published through July 2026 were synthesized. Evidence was organized according to Compression morphology, Endoscopic corridor, Root or cord target, Vertebral stability, and objective decompression endpoints. 
Results. UBE posterior cervical foraminotomy provides substantial improvement in arm pain, neck disability, and neurological function in patients with lateral or foraminal disc herniation and osseous foraminal stenosis. Comparative studies indicate outcomes similar to full-endoscopic posterior foraminotomy and, in selected unilateral disease, noninferior results relative to anterior cervical discectomy and fusion, while preserving segmental motion and avoiding anterior-approach morbidity. Early  evidence  also  supports  multilevel  posterior  biportal  decompression  in  selected  cervical myelopathy with preserved lordosis. However, cervical UBE has a narrow safety margin. Dural tear, spinal cord injury, nerve-root irritation, epidural hematoma, excessive facetectomy, postoperative instability, axial neck pain, and irrigation-related pressure elevation remain relevant. 
Conclusion. Cervical UBE is an adaptable decompressive platform rather than a universal substitute for anterior or open posterior surgery. Safe application requires morphology-based selection, meticulous portal geometry, controlled irrigation, continuous visualization, facet preservation, and readiness for conversion.
Keywords: unilateral  biportal  endoscopy;  cervical  radiculopathy;  cervical  myelopathy; posterior  cervical  foraminotomy;  cervical  disc  herniation;  foraminal  stenosis;  spinal  cord decompression; motion-preserving surgery; cervical instability; minimally invasive spine surgery.