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Updated: Oct 15, 2025
Laminectomy for the Removal of Thoracic Ossification of the Ligamentum Flavum TOLF Using Ultrasonic and Conventional Osteotomes
Published on: April 21, 2023
How i do it: biportal endoscopic thoracic decompression for ossification of the ligamentum flavum
Min-Seok Kang1, Hoon-Jae Chung1, Ki-Han You2
1Department of Orthopedic Surgery, Endoscopic Spine Surgery Center, Bumin Hospital, Seoul, Korea.
Background:
Currently, decompressive laminectomy with or without concomitant fusion is a standard treatment for ossification of the ligamentum flavum (OLF). However, conventional thoracic decompressive laminectomy is not free of the inevitable destruction of the posterior ligamentous complex, and facet injury may lead to various sequelae.
Method:
We used the biportal endoscopic technique for posterior thoracic decompression (BE-PTD) and describe the steps with discussion regarding the indications, advantages, possible complications, and ways to overcome complications.
Conclusion:
BE-PTD can obtain endoscopic visualizations of all the boundaries of the OLF lesion and achieve direct neural decompression of thoracic OLF.
