O-arm-navigated open-door laminoplasty to reduce technical complications in multilevel cervical ossification of the posterior longitudinal ligament: operative video.

Open-door laminoplasty is an established posterior decompression technique for multilevel cervical myelopathy. However, the procedure is technically demanding and may result in complications such as hinge fracture, facet joint violation, and improper gutter placement. The authors present an operative video demonstrating O-arm-based intraoperative navigation during open-door laminoplasty in a 75-year-old man with multilevel ossification of the posterior longitudinal ligament (OPLL) and severe cervical canal stenosis. Navigation allowed precise localization of the medial facet, controlled hinge preparation, and accurate screw placement. Postoperative CT confirmed adequate decompression without complications, suggesting that navigation may enhance the safety and precision of laminoplasty. The video can be found here: https://stream.cadmore.media/r10.3171/2026.4.FOCVID2630.