Endoscopic surgery for cervical myelopathy due to calcification of the ligamentum flavum.

STUDY

DESIGN

Clinical study of endoscopic surgery for calcification of the ligamentum flavum (CLF) in the cervical spine.

OBJECT: The current study evaluates the technical feasibility and clinical outcomes of endoscopic decompression in 3 patients with cervical myelopathy due to CLF.

SUMMARY OF BACKGROUND DATA: CLF is a disease which results in calcium pyrophosphate dihydrate crystal deposition in the ligamentum flavum and which sometimes causes radiculomyelopathy and spinal stenosis. Cervical myelopathy associated with CLF is a rare entity. Most patients with myeloradiculopathy due to CLF were treated by laminectomy.

METHODS

Three patients with cervical myelopathy due to CLF underwent endoscopic partial laminectomy using the METRx system. The operative procedure is presented. Clinical results were evaluated using a scoring system for the treatment of cervical myelopathy adopted by the Japanese Orthopedic Association (JOA score, highest score: 17 points).

RESULTS

There were no dural tears or other intraoperative complications. There were no postoperative complications. All of the patients recognized the improvement of the symptoms caused by spinal cord compression. Postoperative JOA scores in the 3 cases were 17, 17, and 16.5, respectively. Visual analog scale of neck pain was 0/10 in all 3 patients at follow-up. No patients showed evidence of spinal instability after surgery.

CONCLUSIONS

Endoscopic surgery can be used to treat cervical myelopathy due to CLF with minimal soft tissue invasion.