Cervical spondylotic radiculopathy (CSR), which was first described by Ando [
1] in 1952, can be treated through non-surgical and surgical approaches. In 1944, Spurling and Scoville [
2] first recommended that the posterior intervertebral foramen decompression can safely and effectively treat CSR, but cervical pain and muscle sequelae occur after the operation. The first case of anterior cervical disc resection and fusion surgery was accomplished by Smith and Robinson [
3] in 1958, and a good clinical outcome was obtained. Cloward [
4] then reported cervical intervertebral fusion using tenon-type implant and introduced neurostructural decompression to treat the cartilaginous endplate under direct vision. From these studies, cervical intervertebral fusion developed to anterior cervical decompression and fusion, and this technology has been demonstrated to be safe and effective [
5]. The technology produces a high fusion rate and is regarded as the gold standard for treating CSR due to cervical disc herniation [
6]. However, this technique also brings certain problems, such as dysphagia, post-craniotomy haematoma, recurrent laryngeal nerve paralyses, leakage of cerebrospinal fluid, oesophageal perforation, Horner’s syndrome, intervertebral cage displacement, adjacent segment degeneration, pseudoarticulation formation, and other issues brought by fusion [
7‐
10]. With the technological development, many surgical techniques have emerged. Compared with the traditional technologies, novel surgical techniques yield similar surgical outcome while being less damaging to the tissues, exhibit low blood loss, and entail short hospital stay [
11‐
13]. Ruetten et al. [
14] first reported posterior cervical intervertebral disc resection by percutaneous endoscopic surgery in 2007. In a random comparison study on the treatment of 175 cases of nerve-root type cervical spondylosis by percutaneous posterior endoscopic cervical discectomy (PPECD) and anterior cervical decompression and fusion (ACDF), with 2 years of follow-up, Ruetten et al. [
15] reached a remarkable achievement ratio of 87.4% after PPECD treatment. This result demonstrated that PPECD is a safe and effective replacement of traditional ACDF technology. However, the selection of an appropriate surgical method for clinical CSR treatment remains controversial because an ideal surgical method not only needs to produce obvious verifiable curative effect but should also meet the mechanical stability of postoperative physiological requirements. Many scholars believe that PPECD exerts minimal damage to the anatomical structure and offers good postoperative biomechanical performance [
16]. However, studies on the biomechanics of PPECD have been lacking. Therefore, a comparison of postoperative PPECD biomechanics with ACDF after the treatment of nerve-root cervical spondylosis was conducted to compare the biomechanical features of the two procedures.