The authors present a case of cervical myelopathy due to degenerative
stenosis of the spinal canal. They employed an endoscope to aid in the improved
visualization during the release of ligamentous attachments between the cervical dural
sac and the ventral aspect of the cervical lamina during laminoplasty. The patient had
two paraspinal 2 cm incisions through which a MED tubular retractor was placed, and
most of the bony decompression was done using an operating microscope. The lamina
was detached from the lateral masses with a high-speed drill. The bony cuts in this
lateral groove were completed with Kerrison rongeurs. Silk stitches were passed
through the spinous processes to elevate the cervical laminae from the dural sac and
create the posterior expansion of the cord's space. This bilateral laminoplasty was then
secured with mini-titanium plates. The authors present their utilization of the spinal
endoscope in improved visualization of the surgical dissection, which can be
problematic even with an operating microscope through the small exposure afforded by
the MED tubular retractor system. The illumination and magnification helped safely
execute this hybrid operation that employed two different minimally invasive spinal
surgery technologies, including the operating microscope and a spinal endoscope. In
the authors' opinion, such hybridizations may be the stepping stone towards nextgeneration
advances in the cervical spine's minimally invasive surgery.
Keywords: Cervical spondylotic myelopathy, Endoscopy, Laminoplasty.
