ArticleNeurospine2023
Biportal Endoscopic Posterior Thoracic Laminectomy for Thoracic Spondylotic Myelopathy Caused by Ossification of the Ligamentum Flavum: Technical Developments and Outcomes.
Article in Neurospine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Clinical efficacy and safety of unilateral biportal endoscopy for thoracic ossification of ligamentum flavum: A systematic review.Joint diseases and related surgery · 2026Pooled it
- Comparison of endoscopic decompression to open laminectomy in patients with thoracic ossified ligamentum flavum - a systematic review and meta-analysis.Neurosurgical review · 2024Pooled it
- A morphometric analysis of thoracic laminae using 3D reconstruction for guiding unilateral biportal endoscopic surgery.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Midline delta double-door decompression (MDDD), a novel strategy for thoracic ossification of the ligamentum flavum via uni-portal noncoaxial spinal endoscopic surgery (UNSES): a case series.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Radiologic and clinical outcomes of unilateral biportal endoscopic decompression for thoracic ossification of the ligamentum flavum.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Early clinical outcomes of simultaneous biportal endoscopic decompression for tandem spinal stenosis: a single-center retrospective study.Journal of spine surgery (Hong Kong) · 2026Article
- Unilateral biportal endoscopy (UBE) spine surgery for thoracolumbar intervertebral disc diseases in dogs: An ex vivo cadaveric and in vivo preclinical study.Veterinary surgery : VS · 2026Article
- Article
- The Safety and Efficacy of Unilateral Biportal Endoscopic Decompression for the Treatment of Thoracic Ossification of Ligamentum Flavum with Occupancy Ratio > 60%: A Retrospective Cohort Study.Pain and therapy · 2026Article
- Biportal Endoscopic Techniques for Severe Dural Ossification in Thoracic Ossification of the Ligamentum Flavum: Insights From Preoperative Imaging.Neurospine · 2025Article
- Biportal Endoscopic Spinal Surgery for Posterior Decompression of Thoracic Myelopathy Caused by Single-level Thoracic Ossification of the Ligamentum Flavum.Spine surgery and related research · 2025Article
- O-arm navigation-based transforaminal unilateral biportal endoscopic discectomy for upper lumbar disc herniation: an innovative preliminary study.Asian spine journal · 2025Article
- The need for long-term studies to validate endoscopic surgery.Asian spine journal · 2025Article
- The unilateral biportal endoscopy journey: proposing a 10-tier difficulty progression framework for unilateral biportal endoscopy.Asian spine journal · 2025Article
- Uniportal Full Endoscopic 270° Decompression for Thoracic 1-2 Hard Disc Herniation With Ossification of the Ligamentum Flavum.Neurospine · 2024Article
- A narrative review of endoscopic spine surgery: history, indications, uses, and future directions.Journal of spine surgery (Hong Kong) · 2024Review
- Biportal endoscopic cervical open-door laminoplasty to treat cervical spondylotic myelopathy.Acta neurochirurgica · 2024Article
- Biportal endoscopic transforaminal thoracic interbody fusion for the treatment of thoracic myelopathy.Acta neurochirurgica · 2024Article
- Safety and efficacy of one-hole split endoscope technique for surgical treatment of thoracic ossification of the ligamentum flavum.Scientific reports · 2024Article
- Future of Endoscopic Spine Surgery: Insights from Cutting-Edge Technology in the Industrial Field.Bioengineering (Basel, Switzerland) · 2023Review
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveAdvanced biportal endoscopic surgery techniques can be used to treat thoracic myelopathy secondary to ossification of the ligamentum flavum (OLF). This case series elaborates on a feasible biportal endoscopic technique for thoracic OLF removal and evaluates clinical and radiological outcomes.
methodsA biportal endoscopic posterior thoracic laminectomy was performed to remove the thoracic OLF. Surgical techniques have evolved from inside-out piecemeal removal methods to outside-in en bloc removal methods. Preoperative computed tomography was performed to analyze dural ossification and OLF types. Intraoperative videos were reviewed to observe dural ossification and to determine the surgical method. Neurological outcomes were assessed using the Japanese Orthopaedic Association (JOA) score.
resultsClinical symptoms and neurological function improved markedly after surgery (JOA score, preoperative: 12.6 ± 1.0, final follow-up: 15.6 ± 1.2). The mean operation time per segment was not short (106.6 ± 38 minutes). At early experience stages, inside-out piecemeal decompression was used and it caused intraoperative spinal cord injury. However, outside-in en bloc decompression technique did not induce neural complications. Postoperative segmental instability and correlated mechanical back pain were not observed.
conclusionThe biportal endoscopic posterior thoracic approach is an attractive surgical option to treat thoracic spondylotic myelopathy secondary to OLF. Piecemeal inside-out decompression can induce irreversible spinal cord injury, especially in the early experience stages. Outside-in decompression is more efficient and safer than inside-out pattern procedures by minimizing dural manipulation. Nonetheless, this technique is technically demanding and should only be performed in selected patients after acquiring abundant experience with endoscopic spine surgeries.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.