Clinical and radiological results of percutaneous facet cage stabilization and indirect decompression in cervical spondylosis.

OBJECTIVE: To evaluate the clinical and radiological outcomes of percutaneous cervical facet cage stabilization and indirect decompression in patients with cervical spondylotic radiculopathy and myelopathy. MATERIALS AND METHODS: This retrospective study included 25 patients who underwent bilateral percutaneous cervical facet cage placement between 2022 and 2024. Patients with Kang Grade 1-2 cervical stenosis who underwent indirect decompression without additional decompressive surgery and had at least 1 year of follow-up were included. Clinical outcomes were assessed using the Visual Analog Scale scores for neck and arm pain, Modified Japanese Orthopedic Association score, Neck Disability Index, and Oswestry Disability Index. Radiological evaluation included C2-C7 Cobb angle, C2 sagittal vertical axis, foraminal height, facet height, interspinous height, posterior disc space height, and fusion status. RESULTS: The study included 25 patients (14 males and 11 females), with a mean age of 57 years. Significant improvement was observed in all clinical outcome measures at the 1-year follow-up (P < 0.05). Mean facet height increased by 2.4 mm, interspinous height by 2.3 mm, and posterior disc height by 1.9 mm. Foraminal height increased by 2 mm; however, this change was not statistically significant. Cervical sagittal alignment parameters remained unchanged. Fusion was achieved in 23 of 25 patients (92%). Mean operative duration was 34.2 min for single-level procedures and 49.3 min for two-level procedures. One superficial wound infection occurred and resolved with debridement and antibiotic therapy. Two patients required revision surgery because of recurrent symptoms. CONCLUSION: Percutaneous cervical facet cage stabilization with indirect decompression is a minimally invasive and effective treatment option in selected patients with cervical spondylotic radiculopathy and myelopathy. The technique provides satisfactory clinical and radiological outcomes with low morbidity and short operative duration.