Modified Key-Hole Procedure for Treating Cervical Spondylotic Radiculopathy: Cannula Rotary Cutting Method Combined with Long and Short Tongue Cannulas.

Objective: The key-hole technique is highly effective in treating cervical spondylotic radiculopathy (CSR). Recently, various spinal endoscopic techniques have been developed, and we have introduced an innovative catheterization technique known as cannula rotary cutting method combined with long and short tongue cannulas (CRC-LSTCs). The purpose of this article is to evaluate the safety and efficacy of this improved technique in the treatment of CSR.

Methods: From January 2021 to September 2023, 39 patients with CSR underwent the modified key-hole procedure. The following parameters were recorded: the number of X-ray fluoroscopy exposures, operative time, postoperative hospital stay, blood loss, and perioperative complications. All patients were followed up for 12 months. The clinical outcomes were evaluated using the visual analog scale, the Neck Disability Index, the cervical Japanese Orthopaedic Association score, and the improved modified MacNab score.

Results: No severe complications occurred. The number of fluoroscopy procedures was reduced, the operation time was shortened, and patient recovery was accelerated through the combination of CRC-LSTC and key-hole surgery. Significant improvements were observed in visual analog scale, Neck Disability Index, and Japanese Orthopaedic Association scores (P < 0.001). According to the improved MacNab standard, the excellent and good rate was 97.4%. One patient required revision surgery.

Conclusions: The CRC-LSTC combined with the key-hole technique is safe and effective, demonstrating promising short-term outcomes. Further studies with larger cohorts and extended follow-up are needed to confirm its long-term benefits.