Successful Management of Cervical Kyphosis With Myelopathy Across Multiple Vertebral Levels Using Microendoscopic...

Cervical spondylosis can result in myelopathy, manifesting as sensory and/or motor disturbances in the neck, upper extremities, and lower extremities. Conservative treatment, including medication and rehabilitation, can successfully manage the symptoms. However, surgical treatment is necessary when conservative treatment is not effective. Cervical laminectomy, laminoplasty, and fixation surgery, if required, are typical management for patients with cervical myelopathy. In daily practice, we sometimes encounter patients who do not wish for open surgery because of invasiveness. Here, we report a case of myelopathy with kyphosis related to cervical spondylosis in multiple vertebral levels successfully treated with microendoscopic laminectomy. A 68-year-old woman was bothered by myelopathy related to cervical kyphotic spondylosis. Medication did not resolve the myelopathic pain, which had lasted for four years. Radiological examination revealed cervical kyphosis and spinal cord compression from C2 to C4, and decompression and fixation surgery seemed warranted. However, the patient did not wish for open surgery. Thus, we performed microendoscopic laminectomy from C2 to C4. The patient returned home the day after surgery, and the pain resolved postoperatively. No complications occurred. Preoperative kyphosis and cervical alignment improved nine months after surgery. Microendoscopic laminectomy can successfully resolve myelopathy related to cervical spondylosis. This surgical approach appears to be a good option for patients who prefer not to undergo typical open surgery (e.g., conventional laminectomy or laminoplasty). The muscle structure can be preserved due to the minimally invasive nature of the procedure, potentially preventing postoperative kyphosis. This topic warrants further research.