Cervical Endoscopic Laminoplasty for Cervical Myelopathy

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Minimally Invasive Spine Surgery

Background:

• Cervical spondylotic myelopathy (CSM) often requires posterior decompression surgery.
• Conventional posterior approaches can lead to significant postoperative axial neck pain and reduced range of motion (ROM).

Purpose of the Study:

• To evaluate the safety, feasibility, and efficacy of a novel cervical microendoscopic laminoplasty (CMEL) technique.
• To assess CMEL's impact on neurological function, axial pain, and spinal biomechanics in CSM patients.

Main Methods:

• A prospective clinical series involving 45 patients with CSM.
• Endoscopy-assisted bilateral laminoplasty with spinous process-ligament complex and deep extensor muscle retroposition.
• Evaluation using Japanese Orthopedic Association (JOA) scores, visual analog scales (VAS), X-rays, CT, and MRI.

Main Results:

• Significant improvement in JOA scores (8.0 to 13.29) and reduction in VAS pain scores (4.3 to 2.3).
• Stable reconstruction of the expanded laminar arch with no postoperative collapse.
• Increased sagittal spinal canal diameter by 1-3 mm without affecting cervical curvature or ROM.

Conclusions:

• The CMEL technique offers a safe and efficient treatment option for CSM.
• CMEL provides stable laminar reconstruction with less damage to paraspinal structures compared to conventional methods.
• This minimally invasive approach effectively decompressess the spinal cord and improves patient outcomes.