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“Cave-in” decompression under unilateral biportal endoscopy in a patient with upper thoracic ossification of posterior longitudinal ligament: Case report Research Article

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CONCLUSION: UBE spinal decompression for TOPLL showed favorable clinical and radiological results and offers the advantages of minimal soft tissue dissection, shorter hospital stays, and a faster return to daily life activities.
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Front Surg. 2023 Jan 6;9:1030999. doi: 10.3389/fsurg.2022.1030999. eCollection 2022.

ABSTRACT

BACKGROUND: Thoracic ossification of the posterior longitudinal ligament (TOPLL) requires surgery for spinal cord decompression. Traditional open surgery is extremely invasive and has various complications. Unilateral biportal endoscopy (UBE) is a newly developed technique for spine surgery, especially in the lumbar region, but rare in the thoracic spine. In this study, we first used a different percutaneous UBE “cave-in” decompression technique for the treatment of beak-type TOPLL.

METHODS: A 31-year-old female with distinct zonesthesia and numbness below the T3 dermatome caused by beak-type TOPLL (T2-T3) underwent a two-step UBE decompression procedure. In the first step, the ipsilateral lamina, left facet joint, partial transverse process, and pedicles of T2 and T3 were removed. In the second step, a cave was created by removing the posterior third of the vertebral body (T2-T3). The eggshell-like TOPLL was excised by forceps, and the dural sac was decompressed. All procedures are performed under endoscopic guidance. A drainage tube was inserted, and the incisions were closed after compliance with the decompression scope via a C-arm. The patient’s preoperative and postoperative radiological and clinical results were evaluated.

RESULTS: Postoperative CT and MR films conformed complete decompression of the spinal cord. The patient’s lower extremity muscle strength was greatly improved, and no complications occurred. The mJOA score improved from 5 to 7, with a recovery rate of 33.3%.

CONCLUSION: UBE spinal decompression for TOPLL showed favorable clinical and radiological results and offers the advantages of minimal soft tissue dissection, shorter hospital stays, and a faster return to daily life activities.

PMID:36684180 | PMC:PMC9852340 | DOI:10.3389/fsurg.2022.1030999

The London Spine Unit : most established day surgery hospital in the world

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“Cave-in” decompression under unilateral biportal endoscopy in a patient with upper thoracic ossification of posterior longitudinal ligament: Case report

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Front Surg. 2023 Jan 6;9:1030999. doi: 10.3389/fsurg.2022.1030999. eCollection 2022.ABSTRACTBACKGROUND: Thoracic ossification of the posterior longitudinal ligament (TOPLL) requires surgery for spinal cord decompression. Traditional open surgery is extremely invasive and has various complications. Unilateral biportal endoscopy (UBE) is a newly developed technique for spine surgery, especially in the lumbar region, but rare in the thoracic…

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