Abstract
BACKGROUND: This study aimed to describe the least invasive surgical technique of endoscopic decompression for thoracic myelopathy caused by ossification of the ligamentum flavum (OLF) and to review the literature available on the diagnosis and treatment of OLF. OBSERVATIONS: The mean age of the patients was 51.2 (range, 40-62) years, and the mean preoperative, 2-week postoperative, and last follow-up modified Japanese Orthopaedic Association scores were 6.6 (range, 4-10), 9.6 (range, 7-11), and 13 (range, 10-14), respectively. All patients were discharged within 48 hours after the surgery. The mean follow-up period was 13.2 (range, 7-18) months. No complication was found perioperatively, and none of the patients had postoperative instability during the follow-up period. LESSONS: Based on this clinical case series and literature review, the authors conclude that endoscopic decompression surgery is feasible and effective for managing thoracic myelopathy caused by OLF while minimizing surrounding tissue damage. Additionally, it enables shorter periods of hospital stay.