Contralateral-Structure-Preserving Endoscopic Resection of Cervical Osteochondroma: A Technical Note

Area of Science:

• Neurosurgery
• Spine Surgery
• Minimally Invasive Techniques

Background:

• Cervical osteochondromas invading the vertebral canal can cause spinal cord compression.
• Conventional open laminectomy risks cervical deformity by disrupting posterior stabilizing structures.
• A novel contralateral-structure-preserving endoscopic technique is presented for osteochondroma resection.

Purpose of the Study:

• To describe and evaluate a minimally invasive endoscopic technique for cervical osteochondroma resection.
• To assess the safety and efficacy of preserving contralateral spinal structures during resection.
• To compare this technique with conventional open approaches.

Main Methods:

• A 25-year-old patient with a C3 osteochondroma causing spinal cord compression underwent unilateral biportal endoscopic surgery.
• The technique involved partial unilateral laminectomy and a sublaminar endoscopic corridor, preserving contralateral structures.
• Continuous intraoperative neurophysiological monitoring (SSEP and MEP) was employed.

Main Results:

• Complete en bloc resection of the osteochondroma was achieved with negative margins.
• The patient experienced complete symptom resolution and maintained cervical lordosis.
• At 18-month follow-up, the patient remained symptom-free with significant functional improvement and no recurrence.

Conclusions:

• Contralateral-structure-preserving endoscopic resection is a viable minimally invasive alternative for select cervical osteochondromas.
• This technique may reduce the risk of postoperative deformity compared to wide laminectomy.
• Further comparative studies are needed to confirm long-term biomechanical and clinical benefits.