Fully-endoscopic Bilateral Cervical Laminotomy with Unilateral Approach for Cervical Spinal Stenosis and Myelopathy: A Case Series

Presented at SMISS Annual Forum 2018
By Jian Shen MD, PhD
With Jakub Godzik MD, Corey Walker MD, Clinton Morgan MD, Steven Chang MD, Randall Porter MD, Laura Snyder MD, Juan S. Uribe MD, FACS,

Disclosures: Jian Shen MD, PhD B; K2M. C; Joimax. Jakub Godzik MD None, Corey Walker MD None, Clinton Morgan MD None, Steven Chang MD None, Randall Porter MD None, Laura Snyder MD None, Juan Uribe MD, FACS A; Nuvasive. B; Nuvasive. C; Nuvasive. D; Nuvasive. F; Nuvasive,

Introduction:

Expansile laminoplasty or laminectomy is usually used to treat cervical myelopathy attributable to canal stenosis. However, detachment of the posterior cervical muscles is thought to contribute to postoperative axial neck pain and kyphosis, instrumented posterior fusion has to be done with laminectomy. Minimizing the amount of muscular dissection will reduce the likelihood of these complications and patients will have quicker recovery.

Aims/Objectives:

To present a case series using fully endoscopic posterior cervical bilateral decompression technique with a unilateral approach to treat central canal stenosis and myelopathy.

Methods:

Eighteen patients underwent fully endoscopic posterior cervical bilateral laminotomy/decompression with unilateral approach, 1-3 levels of posterior cervical bilateral decompression were accomplished. The preoperative and postoperative records of all the 18 patients were reviewed. Outcome was assessed by neurological status and JOA scores. Follow-up was 12-24 months.

Results:

There was no complication related to the surgery in all 18 patients. Average operative time was 72 minutes/level. Muscle weakness and sensory deficit significantly improved in all patients. Gait improved in 15 patients. Analysis of the mean JOA scores also showed significant improvement.

Conclusions:

Fully-endoscopic posterior cervical decompression for central stenosis is a safe and effective treatment for patients with cervical spinal stenosis and myelopathy.