Unilateral Biportal Endoscopic Posterior Cervical Foraminotomy (UBE-PCF): An Affordable, Motion-Preserving Alternative to Anterior Cervical Discectomy and Fusion for Cervical Radiculopathy — A Case Report with Review of Comparative Evidence
Year: 2026
Type: article
Study design: Case Report
Abstract: Background: Anterior cervical discectomy and fusion (ACDF) continues to be the proven gold standard in managing cervical radiculopathy due to foraminal stenosis, albeit with some limitations such as adjacentsegment degeneration, expense, infection risk from implants, and limitations in bilateral conditions.The purpose of our study is to report the indications, operative technique, and initial clinical and radiographic results of the unilateral biportal endoscopic posterior cervical foraminotomy (UBE-PCF) in managing unilateral cervical radiculopathy at one level and compare the outcome with published data on PCF vs ACDF.Materials and Methods: Case report with descriptive approach was done in a 37-year-old male suffering from right-sided foraminal radiculopathy between C6-C7 level which was unresponsive to the conservative therapy and was treated by UBE-PCF in the prone reverse Trendelenburg position with two-port endoscope technique in the region of C6-C7 level.The clinical, imaging, intraoperative details, and postoperative details like wound healing, CT, and clinical follow-up at 1 month and 3 months were documented.Literature review with focused approach in PubMed/Google Scholar (2011-2025) with the keywords "posterior cervical foraminotomy," "unilateral biportal endoscopic," "ACDF," and "cervical radiculopathy" was done.Results: The patient achieved complete resolution of radicular arm pain, uneventful wound healing with two small linear scars, and full painless cervical range of motion by 3 months, with return to occupational activity by 1 month.Postoperative CT confirmed adequate foraminal decompression without iatrogenic instability.Comparative literature indicates equivalent clinical success between ACDF and PCF, a lower overall complication rate for PCF (4%) than ACDF (7%), comparable reoperation rates, and preliminary evidence of cost-effectiveness favoring PCF.Conclusion: UBE-PCF is a technically feasible, safe, motion-preserving, and cost-conscious alternative to ACDF in appropriately selected patients with unilateral foraminal cervical radiculopathy.This index case supports incorporation of the technique into routine practice, pending validation through larger prospective case series with longer follow-up.
Authors: Srushikesh M, Sanjay Raji, Jeevan M
Institution: Saveetha University
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7202092954