Full-endoscopic posterior cervical foraminotomy: Case-series and technical nuances

Full-endoscopic posterior cervical foraminotomy (FEPCF) is the most minimally invasive procedure that allows to decompress a nerve root in the cervical spine from a posterior approach. We present to the best of our knowledge the first case-series of FEPCF in Switzerland and detail technical nuances including O-arm navigation.The objective of the study is to assess the patients' outcome after this novel procedure. We retrospectively analyzed data from a consecutive series of 6 patients who underwent a FEPCF in our institution, from October 2022 to May 2023. Primary outcome was pain reduction evaluated with the Visual Analog Scale (VAS) for neck and arm, as well as Neck Disability Index (NDI) preoperatively and one month postoperatively. Surgical time, length of stay, opioid consumption, complications were also analyzed. Median pre-operative arm and neck pain (VAS) was 9 and 8.5. One month post-operative arm and neck pain was 2 and 4. Pain reduction was significant for arm pain (mean 7.7 preoperative vs 3.2 postoperative, p = 0.02) but not for neck pain (mean 7.2 preoperative vs 4.2 postoperative, p = 0.14). NDI was 48.4 % ± 7.9 SEM pre-operatively, and 16.4 % ± 8.7 SEM postoperatively, which was highly significant (p = 0.0006). Mean length of stay was 2.3 days in average (avg). Mean surgical time was 126 min avg. Mean total oxycodone consumption during hospital stay was 9.8 mg avg. There was no complication. Full-endoscopic posterior cervical foraminotomy (FEPCF) was a safe and effective procedure for cervical foraminal stenosis in a small group of patients. O-Arm navigation may be used for localization.