Percutaneous Endoscopic Spine Minimally Invasive Technique for Decompression Therapy of Thoracic Myelopathy Caused by Ossification of the Ligamentum Flavum

World Neurosurg. 2018 Jun:114:8-12. doi: 10.1016/j.wneu.2018.02.152. Epub 2018 Mar 7.

Abstract

Background: The percutaneous endoscopic technique through an interlaminar approach is a commonly used minimally invasive procedure in the treatment of lumbar disc herniation, even lumbar spinal stenosis. This report describes complete decompression with the percutaneous endoscopic technique for patients with thoracic ossification of the ligamentum flavum (OLF).

Case description: We performed surgical decompression in of 2 patients with thoracic myelopathy caused by OLF using percutaneous endoscopic surgery through an interlaminar approach. After surgery, the patients described significant improvement in their preoperative neurologic symptoms. Postoperative thoracic computed tomography showed that the ossification of ligaments was completely removed.

Conclusion: We applied the percutaneous endoscopic technique for the treatment of thoracic OLF accomplished direct decompression of the ossified ligaments with minimal trauma and instability. This technique could be used as an alternative choice. However, the fused types should be performed prudently because of the difficulties of the operation.

Keywords: Case report; Interlaminar approach; Ossification of ligamentum flavum; Percutaneous endoscopic technique.

Publication types

  • Case Reports

MeSH terms

  • Decompression, Surgical / methods*
  • Female
  • Humans
  • Ligamentum Flavum / diagnostic imaging
  • Ligamentum Flavum / surgery*
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods*
  • Neuroendoscopy / methods*
  • Ossification, Heterotopic / complications
  • Ossification, Heterotopic / diagnostic imaging
  • Ossification, Heterotopic / surgery*
  • Spinal Cord Compression / diagnostic imaging
  • Spinal Cord Compression / etiology
  • Spinal Cord Compression / surgery*
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / surgery