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

Frontiers in Surgery

Surgery

Qingfeng Hu¹  Zhiyuan Gong²  Xiaowen Qiu²  Xiaowei Jing²  ZiChuan Ping²  Zhuolin Zhong² 

[1] Correspondence:;Department of Orthopedic Surgery, Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, China;

关键词: thoracic ossification of the posterior longitudinal ligament;    cave-in;    decompression;    unilateral biportal endoscopy;    percutaneous endoscopy;   

DOI  :  10.3389/fsurg.2022.1030999

 received in 2022-08-29, accepted in 2022-11-08,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundThoracic 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.MethodsA 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.ResultsPostoperative 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%.ConclusionUBE 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.

【 授权许可】

Unknown   
© 2023 Jing, Gong, Qiu, Zhong, Ping and Hu.