Abstract Background: Thoracic ossification of ligamentum flavum (OLF) is one of the causes of thoracic myelopathy. Open decompression surgery for OLF is associated with many complications. Full-endoscopic decompression has been well established for lumbar surgeries with good outcome and acceptable complications rate. The aim of our study is to describe the technique of full-endoscopic decompression for thoracic OLF and to evaluate its safety and efficacy. Materials and Methods: We studied five patients (aged 39–52 years) who had thoracic OLF at single level, operated by full-endoscopic decompression surgery with minimum 12 months follow up. Interlaminar endoscopic approach was performed for adequate removal of OLF and thoracic cord decompression. The modified Japanese Orthopedic Association (mJOA) score (11 points) was used for clinical evaluation during pre-operative, post-operative and final follow up. Results: Average surgical duration 186 ± 13.87 min with hospitalization period of 3.2 ± 0.83 days. Follow up period ranged from 10 to 18 months. Pre-op mJOA score (6.4 ± 1.14) improved to 7.2 ± 1.09 in the post-operative period and significantly to 9 ± 1.41 at final follow up ( P < 0 .05 ). No major complications were noted in any of the cases except minor dural tear in one patient; and initial neurological worsening in one patient which improved at final follow up. All patients had good to excellent neurological outcome. Conclusion: Interlaminar full-endoscopic decompression for OLF is safe and effective, provides speedy recovery with lesser hospitalization and good clinical outcome with lesser complications rate. Ability to visualize closely, illumination and magnification area of working, and along with precise use of burr are biggest advantages of full endoscopy over other techniques of spine surgery.
Thaker et al. (Thu,) studied this question.