Poster Presentation Sydney Spinal Symposium 2026

Multi-level Uniportal Endoscopic Posterior Cervical Decompression for Cervical Radiculopathy: A Retrospective Multicentre Case Series (#130)

Supreeth Bharadwaj 1 , Gayani Petersingham 1 2 , Wentian Li 1 , Koga Hisashi 3 4 , Ryoji Tominaga 3 4 , Woo-Keun Kwon 5 , Prashanth J Rao 1 2 6 7
  1. Brain and Spine Surgery, BELLA VISTA, NSW, Australia
  2. University of New South Wales, School of Clinical Medicine, SYDNEY, NSW, Australia
  3. Department of Orthopaedics, Iwai Orthopaedic Medical Hospital, Tokyo, Japan
  4. Department of Neurosurgery, wai FESS Clinic, Tokyo, Japan
  5. Department of Neurosurgery, Korea University Guro Hospital, Seoul, Republic of Korea
  6. Department of Neurosurgery, Norwest Private Hospital, BELLA VISTA, NSW, Australia
  7. Department of Neurosurgery, Macquarie University Hospital, MACQUARIE PARK, NSW, Australia

Abstract

Background

Cervical radiculopathy is a disabling condition resulting from degenerative disc herniation or foraminal stenosis. While anterior cervical discectomy and fusion (ACDF) remains the standard surgical treatment, it is associated with complications such as adjacent-segment disease and loss of motion, particularly in multi-level cases. Endoscopic posterior cervical foraminotomy (EPCF) offers a minimally invasive alternative that preserves motion and reduces soft tissue trauma. This study evaluates the safety and outcomes of multi-level uniportal EPCF, addressing the current paucity of multi-centre data in this emerging field.

 

Methods

This multi-centre retrospective case series included 19 patients who underwent multi-level uniportal endoscopic posterior cervical foraminotomy (EPCF) for cervical radiculopathy between 2023 and 2025 across three hospitals in Australia, Japan, and South Korea. Eligible patients were adults with symptomatic cervical radiculopathy secondary to foraminal stenosis or disc herniation refractory to conservative management. Clinical and Radiological data, as well as patient-reported outcome measures (VAS for arm and neck pain; NDI; EQ-5D-5L) were collected pre-operatively and at follow-up intervals up to 2 years. Statistical analysis was performed using paired t-tests to compare pre- and post-operative scores.

 

Results

19 patients (11 males, 8 females; mean age 62.6 ± 12.7 years) underwent multi-level uniportal EPCF for cervical radiculopathy across three centres in Australia, Japan and South Korea. 17 patients had 2-level and 2 patients had 3-level decompressions, with a mean follow up of 9.0 ± 5.7 months. Significant reductions were observed in VAS scores for neck (5.2 ± 3.1 to 2.2 ± 2.4; p < 0.0001), arm (4.4 ± 4.0 to 1.7 ± 2.8; p < 0.05) and NDI (37.1 ± 18.1 to 16.7 ± 16.0; p < 0.0001), indicating significant clinical improvement. Improvements were also seen in EQ-5D-5L domains of personal care, usual activities, and pain (all p <0.05), with mean EQ VAS increasing from 47.8 to 74.1 (p < 0.001). One intraoperative dural tear occurred and was successively repaired. No other complications were observed.

 

Conclusion

This study provides new multi-centre evidence supporting the feasibility, safety and clinical efficacy of multi-level uniportal endoscopic posterior cervical foraminotomy. Significant functional and pain improvements were achieved with minimal complications, highlighting the procedure’s role as a viable motion-preserving alternative to fusion in select multi-level cases.