Biportal Endoscopic Foraminotomy with Unilateral Screw Fixation Using a Dynamic Rod for Radiculopathy Due to Osteoporotic Compression Fracture

Objective: Perform endoscopic surgery for radiculopathy caused by compression fractures and evaluate the results. Methods: A total of 20 patients who underwent biportal endoscopic foraminotomy and unilateral screw fixation using a dynamic rod for radiculopathy secondary to osteoporotic compression fractures were included in this study. All surgeries were performed between July 2021 and January 2025. Patient demographic data, operated level, length of hospital stay, intraoperative blood loss, and operative time were reviewed. Radiological follow-up included assessment of segmental kyphosis, scoliosis, subsidence, and adjacent-level fractures. Complications and pain patterns—separately evaluated for back pain and radiculopathy—were assessed using the visual analog scale (VAS) preoperatively and during follow-up. Only single-level cases were included. Patients with infections, significant stenosis, instability, tumors, prior revision surgery, multilevel pathology, or ambiguous symptoms were excluded. Results: The mean age of the patients was 78.8 years (range, 69–89 years), reflecting an elderly cohort. The mean follow-up period was 13.0 ± 11.9 months (range, 1–41 months). The mean operative time was 164.8 ± 25.7 min, and the mean hospital stay was 10.2 ± 4.6 days (range, 4–25 days). The mean intraoperative blood loss was 126.5 ± 77.6 mL (range, 50–400 mL). One female patient developed postoperative pneumonia, which resolved after appropriate treatment; no other medical complications were observed. Radiculopathy improved significantly immediately after surgery and continued to improve during follow-up. Back pain also improved, but tended to persist to a mild degree. Radiologic evaluation revealed no significant changes in segmental lordosis, and there were no cases of subsidence, scoliosis, or symptomatic screw loosening during the available follow-up period. Conclusions: Biportal endoscopic foraminotomy with unilateral screw fixation may be an effective solution for radiculopathy caused by compression fractures.