Posterior uniportal endoscopic laminotomy for cervical ossification of posterior longitudinal ligament: a case report and technical summary.

BACKGROUND

The management of cervical ossification of posterior longitudinal ligament (OPLL) with unilateral radiculopathy poses significant challenges. Posterior uniportal endoscopic laminotomy offers a minimally invasive alternative, yet its application in OPLL-related stenosis remains technically demanding and underreported.

CASE SUMMARY: A 49-year-old female presented with progressive left upper limb radiculopathy, numbness, weakness, and cervicobrachial pain due to OPLL-induced severe neuroforaminal and lateral recess stenosis at C6-C7 and C7-T1. Through a single 1-cm incision, posterior endoscopic decompression was performed via unilateral laminotomy at both target levels. The procedure was completed in 1.5 h with minimal blood loss. Postoperatively, the patient showed rapid symptomatic improvement, with significant reduction in pain and recovery of grip strength by 6-month follow-up. Integrating contemporary evidence with technical experience, we outline key procedural insights to support the adoption of this technique in selected OPLL cases.

CONCLUSION

Posterior uniportal endoscopic laminotomy is a feasible and effective minimally invasive option for selected OPLL patients with unilateral radiculopathy. It achieves clinical improvement while preserving spinal motion and avoiding fusion-related complications, provided patient selection and surgical technique are optimized.