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March 29, 2026Clinical Spine Surgery A Spine Publication0 citations

Therapeutic Effectiveness of Endo-PCCD in the Lateral Decubitus Position Under Local Anesthesia for Treating Cervical Spondylosis Myelopathy

Key Points

This study aims to evaluate the effectiveness and safety of endoscopic posterior cervical canal decompression performed under local anesthesia.
Conducted an observational study with 58 patients undergoing endoscopic surgery.
Surgery performed in the lateral decubitus position under local anesthesia.
Effectiveness assessed using the NDI, VAS, modified Japanese Orthopaedic Association score, and total efficacy rate at various intervals.
Significant improvement observed in VAS and NDI scores post-surgery.
Modified Japanese Orthopaedic Association score increased at follow-up.
Total efficacy rates were 79% at 1 and 3 months, and 90% at 6 months.
Average hospital stay was reduced to 1.6 days with no severe complications.

Abstract

Study Design: This is an observational study. Objective: The current study aimed to determine the therapeutic effectiveness and safety of endoscopic posterior cervical canal decompression in the lateral decubitus position under local anesthesia for treating cervical spondylosis myelopathy. Summary of Background Data: Cervical spondylotic myelopathy is a disease that can cause disability. Surgical management is an effective therapy for treating cervical spondylotic myelopathy. Especially, the development of endoscopic surgery is enabling patients to undergo less traumatic procedures. However, endoscopic surgery still relies on general anesthesia and requires long operative times in the prone position. This adversely affects patients’ early recovery, leading to prolonged hospitalization and an intangible increase in the financial burden on patients. Methods: In this study, we made a first attempt to perform endoscopic posterior cervical canal decompression in the lateral decubitus position under local anesthesia. Its effectiveness and safety were also observed. Fifty-eight patients were included. The therapeutic efficacy was evaluated by the neck disability index (NDI), visual analog scale (VAS), modified Japanese orthopaedic association score, and total efficacy rate at pre-operation and post-operation 1, 3, and 6 months. Results: All cases achieved good therapeutic effects. The VAS and NDI significantly declined, and the modified Japanese Orthopaedic Association score increased significantly at different follow-up time points compared with the pre-surgery. The total efficacy rate at post-operation 1, 3, and 6 months was 79%, 79%, and 90%, respectively. The average length of stay was 1.6 days. No severe complications were observed. Conclusions: The endoscopic posterior cervical canal decompression surgery in the lateral decubitus position under local anesthesia offers patients a more comfortable experience and safer medical model, further reducing surgical trauma length of inpatient hospital stay, in contrast to that in the prone position under general anesthesia with endotracheal intubation.

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