# Endoscopic cervical open-door laminoplasty: A case and technical report

## TL;DR

This paper describes a new minimally invasive surgical technique for treating cervical spine issues, showing it is easier and more reliable than existing methods.

## Contribution

A novel micro-endoscopic open-door laminoplasty technique with specialized tools for single-surgeon use in narrow spaces.

## Key findings

- The new method achieved sufficient spinal canal expansion and improved myelopathy symptoms.
- Micro-endoscopic ODL was more reliable and easier than full-endoscopic methods using suture anchors.
- Minimal muscle atrophy and successful bone fusion were observed post-surgery.

## Abstract

Open-door laminoplasty (ODL) has been widely used to treat multilevel cervical spondylotic myelopathy. Recently, minimally invasive laminectomy using an endoscope has also been performed. However, postoperative MRI images often show uneven decompression. ODL under endoscopic guidance is a difficult task, and there are very few reports of such procedures.

A 73-year-old male. The patient presented with numbness in both upper limbs and gait disturbance, and spinal stenosis was observed at the C5–7 levels. To perform micro-endoscopic ODL in narrow spaces and by a single surgeon, procedure and fixation tools were developed. Sufficient spinal canal expansion without residual partial stenosis was achieved, leading to the improvement of myelopathy symptoms. Muscle atrophy was minimal, and bone fusion was accomplished.

This minimally invasive method was more effortless and reliable than ODL with a full-endoscope and suture anchor. The fixation was considered sufficiently stable.

While this method may require additional knowledge accumulation in the future, it is considered to be a viable option.

•To perform Micro-endoscopic ODL in narrow spaces and by a single surgeon, procedure and fixation tools were developed.•This surgery was minimally invasive, and both imaging and clinical outcomes were favorable.•ODL using full-endoscope and suture anchors is fundamentally difficult to prevent lamina closure.•This Micro-endoscopic ODL offers more reliable fixation and is easier.

To perform Micro-endoscopic ODL in narrow spaces and by a single surgeon, procedure and fixation tools were developed.

This surgery was minimally invasive, and both imaging and clinical outcomes were favorable.

ODL using full-endoscope and suture anchors is fundamentally difficult to prevent lamina closure.

This Micro-endoscopic ODL offers more reliable fixation and is easier.