Information from the abstract
This structured debate integrates a narrative evidence synthesis with an international practice-pattern survey comparing uniportal endoscopic cervical foraminotomy (PECF), unilateral biportal endoscopic cervical foraminotomy (UBE-CF), and microscopic/tubular posterior cervical foraminotomy. The literature search covered January 1990 to July 5, 2026. Comparative evidence was predominantly retrospective, single-center, and heterogeneous. Background and expertise data were available for 75 respondents, including 74 with endoscopic expertise, and 73 completed all 4 clinical scenarios. Uniportal-only respondents predominantly selected PECF, whereas biportal-only respondents favored UBE-CF. Treatment choices differed across the predefined clinical scenarios, with anterior cervical discectomy and fusion (ACDF) selected by 19 of 73 (26.0%), 35 of 73 (47.9%), 19 of 73 (26.0%), and 49 of 73 respondents (67.1%) in cases 1–4, respectively. These scenarios changed several clinical features simultaneously and do not establish the independent influence of any single feature. Available comparative studies have not established durable superiority of one posterior technique over another. ACDF was the most frequently selected single procedure in the scenario combining retrolisthesis, asymptomatic central stenosis, and motor weakness (case 2) and in the revision scenario (case 4). Platform selection should reflect surgeon expertise, anatomy, and available resources. Multicenter randomized or expertise-based comparative trials with standardized outcomes and long-term follow-up are needed.
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Related topics: Cervical and Thoracic Myelopathy · Spine and Intervertebral Disc Pathology · Cerebrovascular and Carotid Artery Diseases
Thai researcher and institutional participation
Piya Chavalparit · Suthipas Pongmanee · Khanathip Jitpakdee · Weerasak Singhatanadgige · Vit Kotheeranurak · Navamindradhiraj University · Vajira Hospital · Chiang Mai University · Queen Savang Vadhana Memorial Hospital · Chulalongkorn University · King Chulalongkorn Memorial Hospital
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