To investigate the efficacy of posterior cervical spinal nerve root decompression under microscope and percutaneous tubular retractor system in cervical spondylotic radiculopathy (CSR).

A total of 38 patients with CSR, admitted to Department of Neurosurgery, 900^th Hospital of PLA Joint Logistics Team from September 2019 to October 2022 were enrolled consecutively. These patients failed in strict conservative treatment and then changed to posterior cervical spinal nerve root decompression under microscope and percutaneous tubular retractor system. The patients were followed up for (15.71±7.50) months, ranging from 3 to 36 months. The pain visual analogue scale (VAS) and Japanese Orthopedic Association (JOA) scores were recorded and the results of X-ray, CT and MRI of cervical spines were analyzed 1 d before decompression, before discharge and at the last follow-up. C_2-7 sagittal vertical axis (SVA) was measured and compared on CT reconstruction images before decompression and at the last follow-up. The clinical efficacy of these patients was determined according to the formula of improvement rate=([JOA at the last follow-up-preoperative JOA]/[17-preoperative JOA])×100%: 100% improvement rate was defined as cure, improvement rate>60% as significant effect, 25%<improvement rate≤60% as valid treatment, and improvement rate≤25% was defined as invalid treatment.

The VAS and JOA scores were 5.91±0.90 and 11.37±1.50 before decompression, and 0.37±0.31 and 15.76±1.44 at the last follow-up, respectively, with significant differences (P<0.05). Among 38 patients, 12 patients (31.6%) were cured, 18 (47.4%) were significantly effective, 7 (18.4%) were valid, and 1 (2.6%) was invalid, enjoying a total effective rate of 97.4%. Neither dural sac tear or obvious nerve injury during decompression nor infection after decompression were noted. The C_2-7 SVA at the last follow-up ([15.82±0.95] mm) was significantly lower than preoperative C_2-7 SVA ([17.07±1.07] mm, P<0.05).

Posterior cervical nerve root decompression can obtain satisfactory results in single segment CSR; combined application of microscope and percutaneous tubular retractor system can effectively ensure the cervical spine stability and retain the corresponding motion segments.

Cervical spondylosis; Pain; Nerve root; Microsurgery; Sagittal balance