[Objective]To introduce the surgical techniques and preliminary outcomes of endoscopic decompression with facet process preservation for thoracic ossification of ligamentum flavum.[Methods]A total of 24 patients underwent abovementioned surgical treatment for thoracic ossification of ligamentum flavum.The patient was paced in prone position,and local anesthesia combined with intravenous anes-thesia were used.Under C-arm fluoroscopy,a trephine was inserted onto the facet process medial margin of the affected segment.As the en-doscopic system was connected,partial ipsilateral laminectomy was conducted to expose the dura with the visualizing trephine.By using lam-inar rongeur and grinding drill,the ipsilateral lamina was completely resected cephalocaudally.Furthermore,the contralateral lamina was re-moved under the base of the spinous process,and the ossified ligamentum flavum involving the spinal canal were separated and excised grad-ually to finish decompression to both sides of the dural edge,1 cm above and below of the ossified ligament to regain dural pulsation.After complete hemostasis,the incision was closed in layers.[Results]All the patients were operated successfully with no serious complications,such as dural tear,nerve and blood vessel injury.Compared with those preoperatively,VAS score[(6.2±0.9),(1.6±0.7),(1.5±0.5),P＜0.001],ODI score[(55.4±8.2),(18.6±3.1),(8.5±1.2),P＜0.001]significantly improved 3 months postoperatively and at the latest follow-up.Based on the modified Macnab's criteria,the excellent and good rate of clinical outcomes was of 83.3％.[Conclusion]This endoscopic decompression with facet process preservation for thoracic ossification of ligamentum flavum is a safe and effective surgical procedure with advantage of suf-ficient decompression of the spinal canal and avoiding iatrogenic segmental instability in the later stage.
thoracic ossification of ligament flavumendoscopyminimally invasive decompression
NETL
NSTL
万方数据
