Unilateral biportal endoscopic cervical laminectomy with bilateral foraminotomy for cervical myeloradiculopathy: clinical and radiological outcomes at 1 year.

To evaluate the 1-year clinical and radiological outcomes of unilateral biportal endoscopic (UBE) cervical laminectomy with bilateral posterior cervical foraminotomy (PCF) in patients with cervical myeloradiculopathy. Thirty-three patients who underwent UBE cervical laminectomy with bilateral PCF between 2022 and 2024 were retrospectively reviewed. Clinical outcomes were assessed using neck and arm visual analog scale (VAS) scores, Neck Disability Index (NDI), and modified Japanese Orthopaedic Association (mJOA) scores. Radiological parameters including C2/C7 lordosis, segmental angle, disc height, facet length, facet cross-sectional area (CSA), spinal CSA, and surgical foraminal approach angle were evaluated using lateral radiographs, CT, and MRI. Postoperative cervical instability was assessed using flexion-extension radiographs at 1 year. Neck VAS, arm VAS, NDI significantly improved at 1 year, and mJOA scores increased from 10.61 ± 2.42 to 14.30 ± 1.98 (p < 0.001). Spinal canal CSA increased from 94.31 ± 18.02 to 166.65 ± 24.31 mm2 (p < 0.001). Facet length and facet CSA significantly decreased after bilateral PCF, with more facet joint resection observed on the right side compared to the left. C2/C7 lordosis slightly increased postoperatively without kyphotic change, and no patient demonstrated postoperative cervical instability at 1-year follow-up. UBE cervical laminectomy with bilateral PCF provides effective central and bilateral foraminal decompression with favorable clinical and radiological outcomes. This technique may serve as a motion-preserving alternative to fusion procedures in patients with cervical myeloradiculopathy.