The Clinical Efficacy Of Microscopic Subtotal Resection Of The Uncinate Process To Achieve Complete Decompression Of Nerve Roots For Cervical Radiculopathy

OBJECTIVE:To explore the clinical efficacy of microscopic subtotal resection of the uncinate process to achieve complete decompression of nerve roots for cervical radiculopathy.METHODS:This study retrospectively analyzed the clinical data of cervical patients in our hospital from January 2019 to June 2021.All patients underwent microscopic subtotal resection of the uncinate process with an ultrasound bone knife.Operation time and perioperative related complications were recorded;the comparison and analysis of neck and arm visual analogue scales(VAS),neck disability index(NDI)and changes of the preoperative and postoperative follow-up.RESULTS:A total of 42 patients with cervical nerve root canal stenosis underwent subtotal resection.Microscopic subtotal resection of the vertebral joint was not discontinued due to technical difficulties,and no vertebral artery or nerve root damage occurred.The minimum oblique sagittal area of 52 neural root canals was measured in 42 patients,which averaged 15.37±5.61 mm2.The preoperative visual analog scale(VAS)was 5.29 ±1.04 and 6.31±1.41,respectively.The neck disability index(NDI)was 41.17±1.92%.All patients had neck pain and radicular symptoms before surgery,and another 9 patients had symptoms of decreased muscle strength decline in the upper limb of the affected side.Post-operative computed tomography scan showed complete decompression of the nerve root canal.At the last follow-up,the VSA score,NDI were 1.76 ± 0.48,2.26±0.54,and 15.17±1.189%,respectively.The minimum oblique sagittal area(74.39±10.44 mm2)also increased significantly,and was statistically significant(P<0.01).CONCLUSION:microscopic subtotal resection of the uncinate process to achieve complete decompression of nerve roots is a safe and novel anterior decompression of the cervical nerve root.This procedure can be used to treat the cervical radiculopathy caused by severe bony nerve root canal stenosis.This procedure adequately decompresses the nerve root canal while avoiding exposure to the vertebral artery.