Biportal Endoscopic Cervical Laminectomy for Cervical Myelopathy

STUDY DESIGN: Retrospective review. OBJECTIVE: To analyze the clinical and radiologic outcomes of biportal endoscopic cervical laminectomy (BECL) for cervical myelopathy. SUMMARY OF BACKGROUND: Cervical myelopathy is a progressive disease caused by spinal cord compression that significantly impacts quality of life. While open posterior surgeries have been utilized, they carry risks such as postoperative instability, kyphosis, and muscle damage. BECL has emerged as a minimally invasive technique designed to minimize damage. METHODS: Fifteen patients without cervical kyphosis or segmental instability underwent BECL for myelopathy. The endoscopic approach was designed to preserve the multifidus muscle. Clinical outcomes were measured using the Neck Disability Index (NDI) and Visual Analog Scale (VAS) preoperatively and at least 1-year postoperatively. Radiologic outcomes were assessed to evaluate changes in alignment. RESULTS: The mean follow-up period was 18.9±4.4 months. All clinical outcomes showed statistically significant improvement (P<0.05). VAS Neck, VAS Arm, and NDI all demonstrated clinical improvement. Radiologically, there were no statistically significant changes in sagittal alignment. CONCLUSION: In appropriately selected patients, BECL is a safe and effective alternative treatment for myelopathy. It provides excellent clinical outcomes for pain relief and functional recovery while preserving preoperative cervical sagittal alignment in the short term.