• Mukesh Sharma, Nishtha Yadav, Shailendra Ratre, Jitin Bajaj, Arvind Kavishwar, Ketan Hadaoo, Jayant Patidar, Mallika Sinha, Vijay Parihar, Narayan M Swamy, and Yad Ram Yadav.
• Department of Neurosurgery, NSCB Medical College, Jabalpur, India.
• World Neurosurg. 2024 Oct 1; 190: e622e636e622-e636.

BackgroundEndoscopic posterior approach can effectively decompress cervical root and cord secondary to posterior compression. We present our experience in 229 patients using tubular retractor, and the relevant literature is reviewed.MethodsRetrospective analysis of multilevel myelopathy and or radiculopathy was performed. Indications for posterior approach was primary posterior compressions at cord and or root. Combined compression from posterior side and mild to moderate anterior pressure with acceptable lordosis were also decompressed. Bilateral cord decompression and foraminotomy for radiculopathy was performed using tubular retractor.ResultMyelopathy and radiculopathy were present in 220 and 9 patients, respectively. A total of 53 foraminotomy procedures were performed in 36 patients. All patients showed improvement, with the mean preoperative Nurick grade decreasing from 2.72 ± 0.799 to 0.78 ± 0.911 after surgery. There was significant improvement in postoperative Nurick grades compared with preoperative grades (Z-value = 13.306, P < 0.0001). Operative results were better in patients with good preoperative Nurick grades (grades 1 and 2) compared with those with poorer grades (grades 3 and 4). Minor bleeding, small dural tear, and root injury were observed in 42, 4, and 8 patients, respectively.ConclusionsEndoscopic approach was effective and safe for root and cord decompression. This study was limited by its single-center, retrospective design, exclusion of some eligible patients, a short postoperative Nurick grade assessment period of 6 months, and absence of a comprehensive long-term postoperative biomechanical assessment. To validate these results, a prospective multicenter study addressing these limitations is needed.Copyright © 2024 Elsevier Inc. All rights reserved.

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