Assessment of Safety and Efficacy of Full-Endoscopic Ultrasonic Bone Scalpel for Cervical Spondylotic Radiculopathy

Zhenfei Wang,1,* Mengzi Hu,1,2,* Zijin Liu,3 Jinhui Bu,4 Bo He,1,2 Quan Zhang,1,2 Long Xu,5 Juan Gao,1 Chao Ma,1 Guangwang Liu1,2 1Department of Orthopedic Surgery, Xuzhou Central Hospital, Xuzhou, People’s Republic of China; 2Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, People’s Republic of China; 3Xuzhou No.1 Middle School, Class 12 of Senior Two, Xuzhou, People’s Republic of China; 4Department of Spine Surgery, Changsha Central Hospital, University of South China, Changsha, People’s Republic of China; 5The Third Affiliated Hospital of Naval Medical University, Department of Orthopedic Surgery, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guangwang Liu, Email [email protected]: To evaluate the safety and efficacy of the endoscopic ultrasonic bone scalpel (EUBS) in percutaneous endoscopic cervical discectomy (PECD).Methods: A retrospective analysis was conducted on data from 41 patients with cervical spondylotic radiculopathy (CSR) who underwent surgical treatment and were followed up at Xuzhou Central Hospital between January 2019 and June 2023. Among them, 22 patients were treated using EUBS and 19 using a high-speed drill (HSD). The two groups were compared in terms of operative time, bone fenestration time, frequency of surgical field blurring, length of hospital stay, complication rate, postoperative Visual Analog Scale (VAS) and Japanese Orthopaedic Association (JOA) scores, C2– 7 Cobb angle, and intervertebral disc height at the operative level.Results: The follow-up period ranged from 16 to 36 months. The bone fenestration time in the EUBS group was significantly shorter than that in the HSD group (P < 0.05), although no significant differences were observed in total operative time or frequency of surgical field blurring. The postoperative complication rate in the EUBS group was 0%, which was not statistically different from the 5.26% observed in the HSD group. Both groups showed significant improvements in VAS and JOA scores from three months post-surgery to final follow-up, with no significant differences between the groups. Similarly, no significant intergroup differences were found in C2– 7 Cobb angle or intervertebral disc height at any time point.Conclusion: The application of EUBS in PECD is safe and effective for treating CSR. It can reduce bone fenestration time and improve surgical efficiency.Keywords: cervical spondylotic radiculopathy, percutaneous endoscopic cervical discectomy, endoscopic ultrasonic bone scalpel