Hemipartial Laminectomy and Bilateral Flavectomy Technique With Unilateral Approach in Patients With Cervical Spinal Stenosis Due to Ligamentum Flavum Hypertrophy: A Technique Note

The aim of this procedure is to widen the spinal canal by using minimally invasive techniques to do hemipartial laminectomy and bilateral flavectomy in patients with cervical spinal stenosis due to ligamentum flavum hypertrophy. A 66-year-old man presented with increasing neck and right shoulder pain for one year to Koç University Hospital. He reported a three-month history of numbness in his hands. The Japanese Orthopedic Association (JOA) and Visual Analogue Scale (VAS) scores were 15 and 8, respectively. Preoperative magnetic resonance imaging (MRI) revealed spinal canal stenosis at the C3-4 level secondary to ligamentum flavum hypertrophy. Hemi-partial laminectomy at the C3 level, flavectomy, and bilateral decompression were performed using the right unilateral approach. The patient's complaints of symptoms considerably decreased three months later. The VAS and JOA scores were 2 and 16, respectively. This minimally invasive approach can be an alternative to classic laminectomy in patients who have radiculopathy and myelopathy due to posterior origin spinal stenosis in order to safely resolve pain and neurologic dysfunction.