Endoscopic Posterior Cervical Decompression for Ossified Posterior Longitudinal Ligament

Ossification of the posterior longitudinal ligament (OPLL) can lead to cervical myelopathy, particularly in cases of multilevel involvement that pose challenges for effective management. Minimally invasive endoscopic posterior cervical decompression has emerged as a potential alternative to traditional laminectomy surgery. In this chapter, the authors present their clinical experience and report on an illustrative consecutive observational cohort study of thirteen patients with multilevel OPLL and symptomatic cervical myelopathy. The Japanese Orthopaedic Association (JOA) score and neck disability index (NDI) were assessed preoperatively and at a final follow-up of two years postoperatively. The results demonstrated significant improvements in the JOA score and NDI, indicating enhanced functional outcomes. No infections, wound complications, or reoperations were reported. While the two-year outcomes were promising and comparable to those achieved with traditional laminectomy, further investigations are required to assess potential long-term limitations. 

Keywords: Ossified posterior longitudinal ligament, cervical myelopathy, Posterior cervical endoscopy.