Objective The unilateral biportal endoscopic posterior cervical foraminotomy (UBE-PCF) has been recently adopted for unilateral radiating arm pain due to cervical herniated intervertebral disc or foraminal stenosis. We systematically meta-analyzed clinical outcomes and complications of the UBE-PCF and compared them with those of full-endoscopic PCF (FE-PCF).
Methods We systematically searched the PubMed, Embase, and Web of Science until February 29, 2024. Clinical outcomes and complications of the UBE-PCF and FE-PCF were collected and analyzed using the fixed-effect or random-effects model. Clinical outcomes of the UBE-PCF were compared with minimal clinically important difference (MCID) following PCF to evaluate the efficacy of UBE-PCF.
Results Ten studies were included in the meta-analysis. In the random-effects meta-analysis, the Neck Disability Index (NDI), visual analogue scale (VAS) neck, and VAS arm were significantly decreased after the UBE-PCF (p<0.001). The improvement of NDI, VAS neck, and VAS arm were significantly higher than MCID (p<0.05). The improvement of NDI, VAS neck, and VAS arm were not significantly different between the UBE-PCF and FE-PCF (p>0.05). Overall incidence of complications of the UBE-PCF was 6.2% (24 of 390). The most common complication was dura tear (2.1%, 8 of 390). The incidence in overall complications was not significantly different between the UBE-PCF and FE-PCF (p=0.813).
Conclusion We found that the UBE-PCF significantly improved clinical outcomes. Regarding clinical outcomes and complications, the UBE-PCF and FE-PCF were not significantly different. Therefore, the UBE-PCF would be an advantageous surgical option comparable to FE-PCF for unilateral radiating arm pain.
Citations
Citations to this article as recorded by
Biportal Endoscopic Revision Diskectomy for Recurrent Lumbar Disk Herniation Using O-Arm Navigation: 2-Dimensional Operative Video Sang Hyub Lee, Dong-Geun Lee, Choon Keun Park Operative Neurosurgery.2026; 30(3): 481. CrossRef
A large-scale database comparison of contemporary surgical complications in cervical radiculopathy: Cervical disc replacement versus posterior cervical foraminotomy Nicholas J. Cormas, Ariaz Goudarzi, Ved Vengsarkar, J. Allen Chi, Joyce Wang, Li Jin, Stephen Lockey, Xudong Joshua Li Journal of Orthopaedics.2026; 72: 262. CrossRef
Clinical Outcomes and Future Directions of Endoscopic Cervical Spine Surgery: A Systematic Review With Narrative Insights Ryan Wang, Satheeshram Tamilselvan, Ji Soo Ha, Aditya Vedantam, Courtney Rory Goodwin, Nathan Evaniew, Uzondu F. Agochukwu, Konstantinos Margetis, Yoon Ha, Michael Fehlings, Jefferson R. Wilson, Ankit I. Mehta Global Spine Journal.2026;[Epub] CrossRef
Delta large-channel endoscopy versus unilateral biportal endoscopy for cervicothoracic junction disc herniation: a prospective randomized controlled trial Huaibin Wang, Hui Li, Rushuo Wei, Hao Yan, Ruzhan Yao, Weiqiang Liu, Ling Li Journal of Orthopaedic Surgery and Research.2026;[Epub] CrossRef
No surgical site infections observed after lumbar unilateral biportal endoscopy: a multicenter retrospective series of 1566 patients Aurore Sellier, Joseph Cristini, Alexandre Dhenin, Matthieu Vassal, Francois Lechanoine, Nicolas Pellet, Jonathan Lebhar, Guillaume Lonjon Brain and Spine.2026; 6: 105949. CrossRef
Unilateral Biportal Endoscopic Transforaminal Lumbar Interbody Fusion (TLIF) Using 3-Dimensional-Printed Titanium Cages Compared With Open TLIF: A Comparison of Clinical Outcomes and Fusion Rates Sang Hyub Lee, Junghan Seo, Dain Jeong, Sang Youp Han, Dong Hyun Lee, Jae-Won Jang, Dong-Geun Lee, Choon Keun Park Journal of Minimally Invasive Spine Surgery and Technique.2026; 11(Suppl 1): S28. CrossRef
Minimally Invasive Biportal Endoscopic Resection of a Cervical Laminar Osteoid Osteoma Adjacent to the Facet Joint: A Case Report Kwan-Su Song, Joon Young Jung Journal of Minimally Invasive Spine Surgery and Technique.2026; 11(Suppl 1): S102. CrossRef
Nerve Root Herniation Due to Delayed Dural Tear Following Unilateral Laminotomy for Bilateral Decompression With Lumbar Discectomy Using Unilateral Biportal Endoscopy Sang Hyub Lee, Jae-Won Jang, Yong Eun Cho, Choon Keun Park Journal of Minimally Invasive Spine Surgery and Technique.2026; 11(Suppl 1): S109. CrossRef
Complications and their prevention in unilateral biportal endoscopy: a systematic review with narrative insights and practical management algorithms Xavier A. Santander, Martin N. Stienen, Stefan Motov, Héctor U. Quintanilla, Elsa González Pérez Acta Neurochirurgica.2026;[Epub] CrossRef
Unilateral biportal endoscopic partial cervical laminectomy and facetectomy: An ex vivo study and case report Hojung Bae, Haebeom Lee, Sanghyun Nam, Youngjin Jeon, Jaemin Jeong Veterinary Surgery.2026; 55(3): 657. CrossRef
Complications in Minimally Invasive Cervical Spine Surgery–Tubular, Uniportal, and Biportal Endoscopic Surgery (2013–2024) Noah Willett, Chibuikem A. Ikwuegbuenyi, Sean Inzerillo, Eesha Gurav, Mousa Hamad, Ibrahim Hussain, Alan Hernández-Hernández, Galal Elsayed, Osama Kashlan, Roger Härtl Spine.2026; 51(7): E175. CrossRef
Incidence and Risk Factors for 30- and 90-day Reoperations Following Biportal Endoscopic Lumbar Discectomy for Single-Level Lumbar Disc Herniations Sang Hyub Lee, Jae-Won Jang, Hangyu Lee, Limjoon Yoon, Sejin Song, Dain Jeong, Junghan Seo, Sang Youp Han, Bang-Sang Hahn, Jun Young Kim, Jin Seop Hwang, Dong-Geun Lee, Jin-Sung Kim, Dong Chan Lee, Yong Eun Cho, Choon Keun Park Global Spine Journal.2026;[Epub] CrossRef
Comparison of outcomes after unilateral biportal endoscopic discectomy versus percutaneous endoscopic lumbar discectomy for lumbar disc herniation: a systematic review and meta-analysis of observational studies Abdullah Afridi, Ayesha Zulfiqar, Muhammad Waqar Shahid, Fatima Sajjad, Hamnah Sohail, Fazia Khattak, Sabir Khan, Ayesha Naseem, Alina Batool, Muhammad Muneeb, Savira Khattak, Izhar Ul Haq, Ayesha Shahid, Ayesha Nauman, Marium Nisar, Tanveer Hussain, Ahsa Egyptian Journal of Neurosurgery.2026;[Epub] CrossRef
Long-Term Risk of Subsequent Cervical Fusion After Endoscopic Versus Open Cervical Decompression Ryan Wang, Mohammed Rasheed, William Zeng, Alexander T. Hong, Hannah Cho, Syed I. Khalid, Ankit I. Mehta Global Spine Journal.2026;[Epub] CrossRef
Posterior Full-Endoscopic Cervical Foraminotomy and Diskectomy: Surgical Techniques and Review of Outcomes Sang Hun Lee, Wesley M. Durand, Micheal Raad, Amit Jain Journal of the American Academy of Orthopaedic Surgeons.2025; 33(18): e1072. CrossRef
Development and validation of a cost-effective three-dimensional-printed cervical spine model for endoscopic posterior cervical foraminotomy training: a prospective educational study from Turkey Bilal Bahadır Akbulut, Elif Ezgi Çenberlitaş, Mustafa Serdar Bölük, Taşkın Yurtseven, Hüseyin Biçeroğlu Asian Spine Journal.2025; 19(2): 183. CrossRef
Fluid and thermal dynamics in endoscopic spine surgery: What surgeons need to know Dong Hun Kim, Sang Don Kim, Jin Young Kim, Jae Taek Hong, Jung Woo Hur Journal of Clinical Neuroscience.2025; 136: 111287. CrossRef
Biportal Endoscopic Techniques for Severe Dural Ossification in Thoracic Ossification of the Ligamentum Flavum: Insights From Preoperative Imaging Ji Yeon Kim, Su Yong Choi, Dong Chan Lee, Hyeun Sung Kim, Dong Hwa Heo Neurospine.2025; 22(3): 819. CrossRef
Single-Incision Posterior Endoscopic Cervical Foraminotomy for 2-Level Cervical Radiculopathy Florian Wanivenhaus, Christoph Johannes Laux, Sohrab Gollogly, Jin-Sung Kim, Mazda Farshad Journal of Minimally Invasive Spine Surgery and Technique.2025; 10(2): 289. CrossRef
Comparative analysis of clinical and radiological outcomes between ipsilateral and contralateral inclinatory approaches in unilateral biportal endoscopic posterior cervical foraminotomy JinWoo Jung, Sang-Woo Lee, Donghyun Kim, Young San Ko, Dae-Chul Cho, Sang-Kyu Son, Man-Kyu Park European Spine Journal.2025;[Epub] CrossRef
C7–T1 Full-Endoscopic Posterior Foraminotomy and Sequestrectomy Using Navigation Soubach Saravanan, Jean Yves Fournier, Alexandre Simonin Neurospine.2024; 21(4): 1168. CrossRef
Objective Romosozumab is increasingly employed to manage osteoporosis. However, no studies have analyzed its effects on recent osteoporotic vertebral compression fractures (OVCFs). Therefore, this study aimed to evaluate the efficacy of romosozumab compared with teriparatide in managing OVCFs.
Methods The electronic medical records of postmenopausal patients with recent OVCFs who were administered romosozumab or teriparatide for one year from March 2018 to August 2022 were retrospectively reviewed. We compared the 2 groups for demographics, radiological outcomes (compression ratio, Cobb angle, and bone mineral density [BMD]), and clinical outcomes (Numerical Rating Scale [NRS] for back pain).
Results Fifty-five patients with OVCFs, 32 patients treated with romosozumab and 23 with teriparatide, were included in this study. The change of BMD (g/cm2) values was significantly higher (p = 0.016) in the romosozumab (0.04 ± 0.06) than in the teriparatide group (0.00 ± 0.08) in the femur total. Furthermore, in subgroup analysis, the change of BMD (g/cm2) values in the lumbar spine was significantly higher (p = 0.016) in the romosozumab (0.12 ± 0.06) than in the teriparatide group (0.07 ± 0.06) in the lumbar spine. The decrease in NRS was significantly higher (p = 0.013) in the romosozumab (6.6 ± 2.0) than in the teriparatide group (5.5 ± 2.1). However, there was no significant difference in radiologic outcomes between the 2 groups.
Conclusion Our findings suggest that romosozumab may be more effective than teriparatide in treating OVCFs in postmenopausal females, particularly in improving BMD and reducing back pain as measured by NRS.
Citations
Citations to this article as recorded by
Romosozumab mitigates progression from radiological to symptomatic adjacent-level fractures compared to teriparatide Wei-Han Kao, Yi-Shan Yang, Chen-Ling Lan, Wen-Cheng Lo, Yung-Hsiao Chiang, Jiann-Her Lin Osteoporosis International.2026; 37(2): 491. CrossRef
Comparative Radiologic Outcomes of Romosozumab and Teriparatide in Osteoporotic Vertebral Fractures Jun-Seok Lee, Geon-U Kim, Ho-Young Jung, Young-Hoon Kim, Sang-Il Kim, Sangjun Park, Young-Yul Kim, Hyung-Youl Park Journal of Clinical Medicine.2026; 15(6): 2349. CrossRef
Effectiveness of Posterior Long-Segment Fixation for Thoracolumbar Osteoporotic Compression Fractures: A Retrospective Study Jong-Hwan Hong, Jong-Hoon Jung, Ji-Ho Jung, Moon-Soo Han, Jung-Kil Lee World Neurosurgery.2025; 194: 123433. CrossRef
Off-label use of teriparatide for the treatment of a vertebral burst fracture in a young patient: A case report and literature review Tiziano Villa, Vincenzo Zottola, Carlo Mariani, Alberto Borgonovo, Luciano Redenti Trauma Case Reports.2025; 55: 101127. CrossRef
Comparative Analysis of Romosozumab Versus Vertebroplasty With Denosumab: Efficacy, Safety, and Secondary Bone Mineral Density Outcomes Hyun Woong Mun, Jong Joo Lee, Hyun Chul Shin, Tae-Hwan Kim, Seok Woo Kim, Jae Keun Oh Neurospine.2025; 22(1): 69. CrossRef
A Commentary on “Comparative Analysis of Romosozumab Versus Vertebroplasty With Denosumab: Efficacy, Safety, and Secondary Bone Mineral Density Outcomes” Toshihiko Inui Neurospine.2025; 22(1): 78. CrossRef
Comparing the Efficacy of Antiosteoporotic Drugs in Preventing Periprosthetic Bone Loss Following Total Hip Arthroplasty: A Systematic Review and Bayesian Network Meta‐Analysis Yi Tang, Zhaokai Jin, Yichen Lu, Lei Chen, Shuaijie Lv, Taotao Xu, Peijian Tong, Guoqian Chen Orthopaedic Surgery.2024; 16(10): 2344. CrossRef
Commentary on “Deep Learning-Assisted Quantitative Measurement of Thoracolumbar Fracture Features on Lateral Radiographs” Chao-Hung Kuo Neurospine.2024; 21(1): 44. CrossRef
Comparison of osteoanabolic agents (teriparatide and romosozumab) with bisphosphonates in prevention of subsequent vertebral fractures in patients treated for osteoporotic vertebral fracture for 12 months: An observational cohort study Keishi Maruo, Tomoyuki Kusukawa, Masakazu Toi, Tetsuto Yamaura, Masaru Hatano, Hayato Oishi, Kazuma Nagao, Fumihiro Arizumi, Kazuya Kishima, Norichika Yoshie, Toshiya Tachibana Bone Reports.2024; 21: 101762. CrossRef
Incidence and Risk Factors of Sacral Fracture Following Lumbosacral Fusion for Degenerative Spinal Stenosis with a Minimum Follow-Up of 2 Years: A Case–Control Study Sang Hyub Lee, Dong-Hwan Kim, Jin Hoon Park, Dong-Geun Lee, Choon Keun Park, Dong Ho Kang World Neurosurgery.2024; 191: e633. CrossRef
First
Prev
