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Biportal endoscopic unilateral laminotomy with bilateral decompression for the treatment of cervical spondylotic myelopathy

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Abstract

Background

The advantages of biportal endoscopic approaches over conventional open surgery include the preservation of the normal structures, less intraoperative bleeding, fast postoperative recovery, and preservation of the motion segments.

Method

We attempted the posterior biportal endoscopic approach for cervical stenosis at the C5-C6-C7 levels. Biportal endoscopic right ipsilateral hemilaminectomy with bilateral decompression at the C5-C6-C7 levels and right foraminotomy at the C6-C7 level were performed under general anesthesia.

Conclusions

We successfully performed neural decompression at the C5-C6-C7 levels using biportal endoscopic surgery. The biportal endoscopic posterior cervical approach may be an alternative surgical method for treating cervical myelopathy.

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Authors and Affiliations

  1. Department of Neurosurgery, Spine Center, Leon Wiltse Memorial Hospital, Anyang, South Korea

    Jiyeon Kim & Dong Chan Lee

  2. Department of Neurosurgery, Spine Center, Seoul Bumin Hospital, Seoul, South Korea

    Dong Hwa Heo & Hung Tae Chung

Authors
  1. Jiyeon Kim
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  2. Dong Hwa Heo
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  3. Dong Chan Lee
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  4. Hung Tae Chung
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Corresponding author

Correspondence to Dong Hwa Heo.

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The authors declare no competing interests.

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Key points

1. Posterior cervical unilateral laminectomy and bilateral decompression using the biportal endoscopic approach may be an alternative surgical treatment for cervical stenosis associated with myelopathy.

2. This biportal endoscopic technique may minimize injury to the cervical spinous processes, ligaments, and muscles and preserve the motion of the segment.

3. This biportal endoscopic technique should be attempted in highly selective patients with CSM at one or two levels.

4. Although there are controversies regarding the minimally invasive approaches, including endoscopic approaches, in the treatment of cervical myelopathy, these approaches have several benefits such as preservation of muscles and ligaments, small amount of intraoperative bleeding, fast postoperative recovery, and preservation of the motion segments.

5. We successfully performed full decompression of cervical stenosis using a biportal endoscopic posterior approach.

6. Conventional surgeries such as laminoplasty or laminectomy with fusion procedures should be considered for multilevel cervical stenosis instead of minimally invasive microscopic laminotomy or endoscopic laminotomy.

This article is part of the Topical Collection on Spine degenerative

Supplementary Information

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Supplementary file1 Video 1 A video clip of the biportal endoscopic decompressive procedure for cervical stenosis (MP4 128289 KB)

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Kim, J., Heo, D.H., Lee, D.C. et al. Biportal endoscopic unilateral laminotomy with bilateral decompression for the treatment of cervical spondylotic myelopathy. Acta Neurochir 163, 2537–2543 (2021). https://doi.org/10.1007/s00701-021-04921-0

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  • DOI: https://doi.org/10.1007/s00701-021-04921-0

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