Endoscopic Posterior Cervical Decompression for Ossified Posterior Longitudinal Ligament: A Technical Note.

Area of Science:

• Neurosurgery
• Spinal Surgery
• Minimally Invasive Procedures

Background:

• Ossification of the posterior longitudinal ligament (OPLL) can lead to cervical myelopathy, particularly in its multilevel form.
• Multilevel OPLL presents management challenges, with traditional laminectomy being a common surgical approach.
• Minimally invasive endoscopic posterior cervical decompression offers a potential alternative surgical technique.

Purpose of the Study:

• To evaluate the feasibility and outcomes of minimally invasive endoscopic posterior cervical decompression for multilevel OPLL.
• To assess the functional improvement and disability reduction in patients undergoing this procedure.
• To compare the 2-year outcomes with traditional laminectomy data.

Main Methods:

• A consecutive observational cohort study included 13 patients with multilevel OPLL and symptomatic cervical myelopathy.
• Patients underwent endoscopic spine surgery between January 2019 and June 2020.
• Pre- and postoperative Japanese Orthopaedic Association (JOA) scores and Neck Disability Index (NDI) were analyzed at a 2-year follow-up.

Main Results:

• The study included 13 patients (3 women, 10 men) with an average age of 51.15 years.
• Significant improvements were observed in JOA scores (10.85 to 14.77, P < 0.001) and NDI scores (26.61 to 11.12, P < 0.001) at 2 years.
• No infections, wound complications, or reoperations were reported.

Conclusions:

• Direct posterior endoscopic decompression is a feasible surgical option for symptomatic multilevel OPLL when performed by skilled surgeons.
• The 2-year outcomes are encouraging and comparable to traditional laminectomy results.
• Further long-term studies are necessary to ascertain any potential long-term shortcomings.