Uniportal Endoscopic Cervical Decompression For Myelopathic Spinal Stenosis

This article demonstrates the step-by-step surgical technique of endoscopic cervical decompression for myelopathic cervical spinal stenosis. The procedure allows precise neural decompression under continuous endoscopic visualization while minimizing muscle disruption and aiming to preserve posterior stabilizing structures. The key steps include portal docking, controlled drilling of the osseous structures, and removal of the ligamentum flavum to achieve sufficient spinal cord decompression while avoiding neural injury. Despite its minimally invasive advantages, endoscopic cervical decompression can be technically challenging, particularly for surgeons in the early learning phase, due to the narrow working corridor and close proximity to critical neural elements. Therefore, this video article provides detailed visual guidance and explanations of common technical difficulties, anatomical considerations, and practical strategies to overcome these challenges. By highlighting both procedural steps and potential pitfalls, this protocol demonstrates the feasibility of endoscopic cervical decompression and presents representative institutional outcomes. It aims to facilitate safer and more effective adoption of this minimally invasive treatment option for cervical myelopathy in appropriately selected patients.