Uniportal full endoscopic spinous process–preserving laminectomy for bilateral decompression in cervical stenotic myelopathy: patient series

BACKGROUND: Endoscopic decompression for cervical stenotic myelopathy has several advantages over conventional open surgery. However, sometimes performing bilateral decompression, especially contralateral decompression, can be dangerous. The cervical spine has specific characteristics, including a shallower lamina angle and thinner lamina than the lumbar or thoracic lamina. These characteristics may cause cord compression when instruments approach the contralateral side of the lamina. This article introduces a novel surgical technique that can overcome the specificities of the cervical spine and discusses the efficacy and safety of uniportal full endoscopy for cervical decompression. OBSERVATIONS: Fourteen patients underwent uniportal full endoscopic spinous process–preserving laminectomy (ESP-L) for bilateral decompression of multilevel cervical stenotic myelopathy. The mean follow-up period was 13.44 months (range: 4–17 months). The preoperative and postoperative cervical spine angle and cervical range of motion did not differ significantly. The Japanese Orthopaedic Association score significantly improved postoperatively. The numeric rating scale scores significantly improved postoperatively. The mean duration of postoperative hospitalization was 2.3 days. LESSONS: ESP-L is a new, safe, effective, and noninvasive technique that can achieve complete decompression of multilevel cervical stenotic myelopathy.