Endoscopic cervical open-door laminoplasty: A case and technical report

INTRODUCTION: Open-door laminoplasty (ODL) has been widely used to treat multilevel cervical spondylotic myelopathy. Recently, minimally invasive laminectomy using an endoscope has also been performed. However, postoperative MRI images often show uneven decompression. ODL under endoscopic guidance is a difficult task, and there are very few reports of such procedures. PRESENTATION OF CASE: A 73-year-old male. The patient presented with numbness in both upper limbs and gait disturbance, and spinal stenosis was observed at the C5-7 levels. To perform micro-endoscopic ODL in narrow spaces and by a single surgeon, procedure and fixation tools were developed. Sufficient spinal canal expansion without residual partial stenosis was achieved, leading to the improvement of myelopathy symptoms. Muscle atrophy was minimal, and bone fusion was accomplished. DISCUSSION: This minimally invasive method was more effortless and reliable than ODL with a full-endoscope and suture anchor. The fixation was considered sufficiently stable. CONCLUSIONS: While this method may require additional knowledge accumulation in the future, it is considered to be a viable option.