Neurospine

Clinical Study – Cervical Spine

Flexion K-Line Status Predicts Surgical Strategy in Multilevel Cervical Ossification of the Posterior Longitudinal Ligament: A Multicenter Comparison of Laminoplasty and Laminectomy With Fusion: Jun Jae Shin, Sun Joon Yoo, Se Jun Park, Dong Kyu Kim, Hyun Jun Jang, Bong Ju Moon, Kyung Hyun Kim, Jeong Yoon Park, Sung Uk Kuh, Dong Kyu Chin, Keun Su Kim, Yong Eun Cho, Chang Kyu Lee, Dong Ah Shin, Seong Yi, Keung Nyun Kim, Joongkyum Shin, Yoon Ha; Neurospine 2025;22(4):937-948. Published online December 31, 2025; DOI: https://doi.org/10.14245/ns.2551108.554

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Flexion K-Line Status Predicts Surgical Strategy in Multilevel Cervical Ossification of the Posterior Longitudinal Ligament: A Multicenter Comparison of Laminoplasty and Laminectomy With Fusion

Neurospine. 2025;22(4):937-948. Published online December 31, 2025

DOI: https://doi.org/10.14245/ns.2551108.554

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Flexion K-Line Status Predicts Surgical Strategy in Multilevel Cervical Ossification of the Posterior Longitudinal Ligament: A Multicenter Comparison of Laminoplasty and Laminectomy With Fusion

Neurospine. 2025;22(4):937-948. Published online December 31, 2025

DOI: https://doi.org/10.14245/ns.2551108.554

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Objective
To evaluate the clinical significance of a negative K-line in the neck flexion position (FK-line [-]), which indicates that cervical ossification of the posterior longitudinal ligament (OPLL) crosses the K-line during flexion, and to compare surgical outcomes between laminoplasty (LP) and laminectomy with fusion (LF) for multilevel FK-line (-) cervical OPLL.
Methods
A total of 349 patients with multiple cervical OPLL who underwent posterior decompression surgery (LP or LF) with a minimum of 2 years of follow-up were stratified by FK-line status. Clinical and radiological parameters were compared between the FK-line (+) and FK-line (-) groups. Subgroup analysis of FK-line (-) patients evaluated the efficacy of LP versus LF. Multivariate regression identified predictors of neurological recovery.
Results
Patients with FK-line (-) OPLL exhibited a smaller FK-line distance, more kyphotic alignment, greater cervical flexion, and lower recovery ratios compared to those with FK-line (+). In the FK-line (-) subgroup, LF achieved a significantly greater increase in FK-line distance, better correction of the flexion angle, and more neurological recovery than LP. Multivariate analyses identified postoperative FK-line distance, C2–7 flexion angle, and preoperative dynamic extension reserve as independent predictors of neurological outcomes.
Conclusion
FK-line status reflects the sagittal cord position and predicts surgical outcomes in cervical OPLL. In FK-line (-) patients, LF provides better neurological recovery and more effective posterior cord shift and kyphotic alignment correction than LP. Incorporating FK-line assessment to guide surgical planning could improve individualized treatment outcomes for multilevel OPLL.

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A Commentary on “Flexion K-Line Status Predicts Surgical Strategy in Multilevel Cervical Ossification of the Posterior Longitudinal Ligament: A Multicenter Comparison of Laminoplasty and Laminectomy With Fusion”
John H. Chi
Neurospine.2025; 22(4): 951. CrossRef
A Commentary on “Flexion K-Line Status Predicts Surgical Strategy in Multilevel Cervical Ossification of the Posterior Longitudinal Ligament: A Multicenter Comparison of Laminoplasty and Laminectomy With Fusion”
Yutaro Kanda
Neurospine.2025; 22(4): 949. CrossRef
From the Editor-in-Chief: Featured Articles in the December 2025 Issue
Inbo Han
Neurospine.2025; 22(4): 877. CrossRef

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Minimally Invasive Surgery

Biportal Endoscopic Techniques for Severe Dural Ossification in Thoracic Ossification of the Ligamentum Flavum: Insights From Preoperative Imaging: Ji Yeon Kim, Su Yong Choi, Dong Chan Lee, Hyeun Sung Kim, Dong Hwa Heo; Neurospine 2025;22(3):819-828. Published online September 30, 2025; DOI: https://doi.org/10.14245/ns.2550338.169

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Biportal Endoscopic Techniques for Severe Dural Ossification in Thoracic Ossification of the Ligamentum Flavum: Insights From Preoperative Imaging

Neurospine. 2025;22(3):819-828. Published online September 30, 2025

DOI: https://doi.org/10.14245/ns.2550338.169

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Biportal Endoscopic Techniques for Severe Dural Ossification in Thoracic Ossification of the Ligamentum Flavum: Insights From Preoperative Imaging

Neurospine. 2025;22(3):819-828. Published online September 30, 2025

DOI: https://doi.org/10.14245/ns.2550338.169

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Objective
This study evaluates surgical strategies based on preoperative computed tomography (CT) findings during unilateral biportal endoscopic (UBE) surgery for thoracic ossification of the ligamentum flavum (OLF) with dural ossification.
Methods
This retrospective study included patients undergoing posterior thoracic laminectomy via UBE surgery to treat symptomatic thoracic stenosis due to OLF. Clinical outcomes were assessed using visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) scores, alongside analyses of preoperative CT and intraoperative videos for dural ossification characteristics.
Results
A total of 34 patients participated, showing significant improvements in VAS and JOA scores postoperatively. All focal dural ossifications exhibiting the tram-track sign were effectively excised without significant dural defects. The circumferential floating technique was employed for cases with the bridge sign, whereas wide excision was warranted for those with the comma sign.
Conclusion
UBE surgery effectively manages progressive thoracic OLF associated with dural ossification. Preoperative CT imaging is essential for assessing dural involvement and guiding surgical techniques. Microscopic surgery is recommended for inexperienced surgeons requiring wide dural excision.

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The Safety and Efficacy of Unilateral Biportal Endoscopic Decompression for the Treatment of Thoracic Ossification of Ligamentum Flavum with Occupancy Ratio > 60%: A Retrospective Cohort Study
Lei Qi, Biteng Xu, Xiangji Guo, Gaoya Yu, Yuxuan Yang, Haozhi Yu, Liang Wang
Pain and Therapy.2026; 15(1): 379. CrossRef
Biportal endoscopic spinal surgery for thoracic ossification of the ligamentum flavum: a study of different classification types and surgical outcomes
Honggang Wang, Dongqing He, Ruxing Liu, Jie Yuan, Yongfeng Wang
Frontiers in Neurology.2026;[Epub] CrossRef

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Narrative Review on Postoperative Pain Management Following Spine Surgery: Crystal Yu, Michael Madsen, Olutola Akande, Michael Y. Oh, Ryan Mattie, David W. Lee; Neurospine 2025;22(2):403-420. Published online June 30, 2025; DOI: https://doi.org/10.14245/ns.2550410.205

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Narrative Review on Postoperative Pain Management Following Spine Surgery

Neurospine. 2025;22(2):403-420. Published online June 30, 2025

DOI: https://doi.org/10.14245/ns.2550410.205

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Narrative Review on Postoperative Pain Management Following Spine Surgery

Neurospine. 2025;22(2):403-420. Published online June 30, 2025

DOI: https://doi.org/10.14245/ns.2550410.205

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Postoperative pain is an inevitable consequence of spine surgery, yet there remains no universal consensus on the optimal pain management strategy. The complexity of spine procedures, coupled with patient variability, necessitates a multifaceted approach to pain control. Over time, numerous strategies have emerged, each with varying levels of effectiveness. Pharmacological approaches, including multimodal analgesia, local anesthetic infusions, and gabapentinoids, provide relief for both acute and chronic pain. Additionally, perioperative strategies such as enhanced recovery after surgery (ERAS) protocols have demonstrated benefits in optimizing pain control and recovery outcomes. Beyond pharmacological interventions, physical therapy has become a cornerstone of postoperative pain management, aiding in functional recovery and reducing reliance on medications. For patients with refractory or chronic pain, neuromodulatory techniques such as spinal cord stimulation and intrathecal injections offer alternative solutions. Despite the breadth of evidence-based strategies available, limitations persist, including opioid dependence, the complexity of multimodal regimens leading to suboptimal compliance, and cases of refractory pain. These challenges underscore the importance of tailoring pain management approaches to individual patient needs, ensuring a balance between effectiveness and safety. This narrative review of evidence seeks to explore the multifaceted nature of pain management following spine surgery, highlighting the challenges and evolving strategies in optimizing patient outcomes.

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International Journal of Science and Healthcare Research.2026; : 48. CrossRef
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Clinical and Radiological Outcomes in C2 Recapping Laminoplasty for the Pathologies in the Upper Cervical Spine: Dong Hun Kim, Jae Taek Hong, Jung Woo Hur, Il Sup Kim, Ho Jin Lee, Jong Beom Lee; Neurospine 2024;21(2):565-574. Published online June 30, 2024; DOI: https://doi.org/10.14245/ns.2347270.635

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Clinical and Radiological Outcomes in C2 Recapping Laminoplasty for the Pathologies in the Upper Cervical Spine

Neurospine. 2024;21(2):565-574. Published online June 30, 2024

DOI: https://doi.org/10.14245/ns.2347270.635

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Clinical and Radiological Outcomes in C2 Recapping Laminoplasty for the Pathologies in the Upper Cervical Spine

Neurospine. 2024;21(2):565-574. Published online June 30, 2024

DOI: https://doi.org/10.14245/ns.2347270.635

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Objective
To evaluate C2 muscle preservation effect and the radiological and clinical outcomes after C2 recapping laminoplasty.
Methods
Fourteen consecutive patients who underwent C2 recapping laminoplasty around C1–2 level were enrolled. To evaluate muscle preservation effect, the authors conducted a morphological measurement of extensor muscles between the operated and nonoperated side. Two surgeons measured the cross-sectional area (CSA) of obliquus capitis inferior (OCI) and semispinalis cervicis (SSC) muscle before and after surgery to determine atrophy rates (ARs). Additionally, we examined range of motion (ROM), sagittal vertical axis (SVA), neck visual analogue scale (VAS), Neck Disability Index (NDI), and Japanese Orthopaedic Association (JOA) score to assess potential changes in alignment and consequent clinical outcomes following posterior cervical surgery.
Results
We measured the CSA of OCI and SSC before surgery, and at 6 and 12 months postoperatively. Based on these measurements, the AR of the nonoperated SSC was 0.1% ± 8.5%, the AR of the operated OCI was 2.0% ± 7.2%, and the AR of the nonoperated OCI was -0.7% ± 5.1% at the 12 months after surgery. However, the AR of the operated side’s SSC was 11.2% ± 12.5%, which is a relatively higher value than other measurements. Despite the atrophic change of SSC on the operated side, there were no prominent changes observed in SVA, C0–2 ROM, and C2–7 ROM between preoperative and 12 months postoperative measurements, which were 11.8 ± 10.9 mm, 16.3° ± 5.9°, and 48.7° ± 7.7° preoperatively, and 14.1 ± 11.6 mm, 16.1° ± 7.2°, and 44.0° ± 10.3° at 12 months postoperative, respectively. Improvement was also noted in VAS, NDI, and JOA scores after surgery with JOA recovery rate of 77.3% ± 29.6%.
Conclusion
C2 recapping laminoplasty could be a useful tool for addressing pathologies around the upper cervical spine, potentially mitigating muscle atrophy and reducing postoperative neck pain, while maintaining sagittal alignment and ROM.

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Orthopaedic Surgery.2026; 18(1): 74. CrossRef
Techniques for Cervical Laminoplasty
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Global Spine Journal.2026;[Epub] CrossRef
C2-Involving Cervical Ossification of the Posterior Longitudinal Ligament (OPLL): Dome-like Laminoplasty Versus Laminectomy With Fusion
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NASS/Neurospine Endoscopic Spine Surgery Special Issue

Biportal Endoscopic Posterior Thoracic Laminectomy for Thoracic Spondylotic Myelopathy Caused by Ossification of the Ligamentum Flavum: Technical Developments and Outcomes: Ji Yeon Kim, Ji Soo Ha, Chang Kyu Lee, Dong Chan Lee, Hyun Jin Hong, Su Yong Choi, Choon Keun Park; Neurospine 2023;20(1):129-140. Published online March 31, 2023; DOI: https://doi.org/10.14245/ns.2346060.030

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Biportal Endoscopic Posterior Thoracic Laminectomy for Thoracic Spondylotic Myelopathy Caused by Ossification of the Ligamentum Flavum: Technical Developments and Outcomes

Neurospine. 2023;20(1):129-140. Published online March 31, 2023

DOI: https://doi.org/10.14245/ns.2346060.030

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Biportal Endoscopic Posterior Thoracic Laminectomy for Thoracic Spondylotic Myelopathy Caused by Ossification of the Ligamentum Flavum: Technical Developments and Outcomes

Neurospine. 2023;20(1):129-140. Published online March 31, 2023

DOI: https://doi.org/10.14245/ns.2346060.030

Close

Objective
Advanced biportal endoscopic surgery techniques can be used to treat thoracic myelopathy secondary to ossification of the ligamentum flavum (OLF). This case series elaborates on a feasible biportal endoscopic technique for thoracic OLF removal and evaluates clinical and radiological outcomes.
Methods
A biportal endoscopic posterior thoracic laminectomy was performed to remove the thoracic OLF. Surgical techniques have evolved from inside-out piecemeal removal methods to outside-in en bloc removal methods. Preoperative computed tomography was performed to analyze dural ossification and OLF types. Intraoperative videos were reviewed to observe dural ossification and to determine the surgical method. Neurological outcomes were assessed using the Japanese Orthopaedic Association (JOA) score.
Results
Clinical symptoms and neurological function improved markedly after surgery (JOA score, preoperative: 12.6 ± 1.0, final follow-up: 15.6 ± 1.2). The mean operation time per segment was not short (106.6 ± 38 minutes). At early experience stages, inside-out piecemeal decompression was used and it caused intraoperative spinal cord injury. However, outside-in en bloc decompression technique did not induce neural complications. Postoperative segmental instability and correlated mechanical back pain were not observed.
Conclusion
The biportal endoscopic posterior thoracic approach is an attractive surgical option to treat thoracic spondylotic myelopathy secondary to OLF. Piecemeal inside-out decompression can induce irreversible spinal cord injury, especially in the early experience stages. Outside-in decompression is more efficient and safer than inside-out pattern procedures by minimizing dural manipulation. Nonetheless, this technique is technically demanding and should only be performed in selected patients after acquiring abundant experience with endoscopic spine surgeries.

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Ji Yeon Kim, Kyoung Mo Kim, Su Yong Choi, Dong Hwa Heo, Hyeun Sung Kim, Hyeun Jin Hong, Dong Chan Lee
Journal of Minimally Invasive Spine Surgery and Technique.2024; 9(2): 102. CrossRef
Unilateral Biportal Endoscopic Decompression for Thoracic Spinal Stenosis Secondary to Ossification of the Ligamentum Flavum
Cheol Woong Park, Borriwat Santipas
Journal of Minimally Invasive Spine Surgery and Technique.2024; 9(2): 186. CrossRef
Uniportal Full Endoscopic 270° Decompression for Thoracic 1–2 Hard Disc Herniation With Ossification of the Ligamentum Flavum
Hyun-Jin Ma, Sang Ho Lee, Chan Hong Park
Neurospine.2024; 21(4): 1108. CrossRef
Uniportal Thoracic Endoscopic Unilateral Laminotomy with Bilateral Decompression of Thoracic Ossification of Ligamentum Flavum: A Systematic Review of Current Literature
Pang Hung Wu, Brian Zhao Jie Chin, Hyeun Sung Kim, Seth Ian Sim, Il-Tae Jang
World Neurosurgery.2023; 178: 340. CrossRef
Complications of Endoscopic Thoracic Spine Surgery: Overview and Complication Avoidance
Man-Kyu Park, Jeong-Yoon Park, Sang-Kyu Son
World Neurosurgery.2023; 179: 127. CrossRef
Lumbar Endoscopic Unilateral Laminotomy With Bilateral Decompression Surgery in Severe Lumbar Stenosis Under Electrophysiological Monitoring-Focused on Full-Visualized Trephine/Osteotome
Ning-Ning Dou, Hao-lin Wang, Shao-Zhen Hu, Zheng-Nan Huang, Jun Zhong, Shi-Ting Li
Neurospine.2023; 20(3): 1040. CrossRef
Overview and Prevention of Complications During Biportal Endoscopic Thoracic Spine Surgery
Man-Kyu Park, Sang-Kyu Son
Journal of Minimally Invasive Spine Surgery and Technique.2023; 8(2): 165. CrossRef
Future of Endoscopic Spine Surgery: Insights from Cutting-Edge Technology in the Industrial Field
Woon-Tak Yuh, You-Sang Lee, Il Choi
Bioengineering.2023; 10(12): 1363. CrossRef

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Location Distribution of Fistulas and Surgical Strategies for Spinal Extradural Meningeal Cysts: A Retrospective Analysis of 30 Cases at a Single Center: Qiang Jian, Gang Song, Zhenlei Liu, Wanru Duan, Jian Guan, Fengzeng Jian, Zan Chen; Neurospine 2022;19(1):188-201. Published online January 2, 2022; DOI: https://doi.org/10.14245/ns.2142526.263

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Location Distribution of Fistulas and Surgical Strategies for Spinal Extradural Meningeal Cysts: A Retrospective Analysis of 30 Cases at a Single Center

Neurospine. 2022;19(1):188-201. Published online January 2, 2022

DOI: https://doi.org/10.14245/ns.2142526.263

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Location Distribution of Fistulas and Surgical Strategies for Spinal Extradural Meningeal Cysts: A Retrospective Analysis of 30 Cases at a Single Center

Neurospine. 2022;19(1):188-201. Published online January 2, 2022

DOI: https://doi.org/10.14245/ns.2142526.263

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Objective
This study aimed to illustrate the features of fistula location distribution, surgical strategies, and outcomes in spinal epidural meningeal cysts (SEMCs).
Methods
The authors searched and reviewed the medical records for cases of SEMCs. Imaging features, operative reports, and media were reviewed to accurately describe the surgical techniques employed. We recorded the level and laterality of the fistula according to the operative report and the media. Consistency analysis was performed on the dominant laterality of the cyst on preoperative axial magnetic resonance imaging and laterality of the fistula in the operative media or report. When cyst and fistula lateralities were the same, they were considered consistent. Finally, the Japanese Orthopedic Association (JOA) score was used to obtain patient-reported results at each follow-up.
Results
Thirty patients with SEMCs were identified. Fistula repair was performed in all patients. Two patients experienced cyst recurrence after surgery and were repaired during the second surgery. Based on imaging findings, SEMCs mostly occurred in the thoracolumbar junction. Most of the fistulas (87.88%) were at the T12 or L1 levels. In patients with multiple adjacent SEMCs, the fistula may be at one end of the cyst rather than in the middle level of the cyst. A fistula laterality of 72.72% was consistent with cyst laterality. The JOA improvement rate was 61.84% ± 26.63%.
Conclusion
Most fistulas were always located at the T12–L1 level as well as the middle level of the cyst, which is always consistent with cyst laterality. In patients with multiple adjacent SEMCs, the fistula may be at one end of the cyst. Cleft closure is key to healing SEMCs.

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Outcome of utilizing real-time contrast medium to detect the fistulas in spinal epidural arachnoid cysts and treat with minimally invasive surgery
Wei Gao, Qixuan Jiang, Tianjian Liu, Aiqin Chen, Xiaohang Jiang, Xinben Hu, Chi Gu, Yajuan Tang, Fang Shen, Jingyin Chen, Guangyu Ying, Yongjian Zhu
European Spine Journal.2025; 34(2): 472. CrossRef
Multiple spinal extradural arachnoid cysts presenting as compressive myelopathy in a teenager: case report and literature review with special emphasis on postoperative spine deformity in the current minimally invasive era
Rajeev Sharma, Sivaraman Kumarasamy, Shashi Kala Tiwary, Shweta Kedia, Dattaraj Sawarkar, Ramesh Doddamani, Rajinder Kumar Laythalling
Child's Nervous System.2024; 40(3): 729. CrossRef
Expanding the Horizons of Minimally Invasive Spine Surgery: Experience of the Destandau Technique for the Treatment of Multiple Spinal Diseases
Anant Mehrotra, Kavindra Singh, Soumen Kanjilal, Priyadarshi Dikshit, Ashutosh Kumar, Pawan Kumar Verma, Kuntal Kanti Das, Awadhesh Kumar Jaiswal, Raj Kumar
World Neurosurgery.2024; 181: e970. CrossRef
A novel subtype classification and corresponding surgical strategies for spinal dural cysts–a report of 104 cases
Guangjian He, Xingsen Xue, Xin Chen, Xing Fang, Hongyan Zhang, Wanjiang Wu, Jiantao Shi, Rong Hu, Jiangkai Lin, Weihua Chu
The Spine Journal.2024; 24(12): 2322. CrossRef
Pediatric spinal arachnoid cysts with compressive myelopathy: single-center experience and update on surgical management
Vamshi Reddy Parapati, Ganesh Divakar, Easwer HV, Gowtham Matham, Krishnakumar Kesavapisharady, Antony Stanley
Child's Nervous System.2024; 40(12): 4055. CrossRef
Spinal extradural arachnoid cysts: A novel formation mechanism and dural defect location technology
He Huang, Min Wei, Quanwei Zhou, Renjun Peng, Xiping Ding, Jian Xi
Heliyon.2023; 9(1): e12969. CrossRef
Sacral terminal filar cyst: a distinct variant of spinal meningeal cyst and midterm clinical outcome following combination resection surgery
Guozhong Lin, Chenlong Yang, Tao Yu, Jia Zhang, Yu Si, Chao Wu, Changcheng Ma, Bin Liu, Jun Yang, Jingcheng Xie
Frontiers in Surgery.2023;[Epub] CrossRef
Impact of Surgical Timing on Neurological Outcomes for Spinal Arachnoid Cyst: A Single Institution Series
Grégoire P. Chatain, Keshari Shrestha, Michael W. Kortz, Stephanie Serva, Patrick Hosokawa, Ryan C. Ward, Akal Sethi, Michael Finn
Neurospine.2022; 19(2): 453. CrossRef
Clinical and imaging features of spinal extradural arachnoid cysts: a retrospective study of 50 cases
Ahmed K. Ahmed, Bhrugun Anisetti, Thien Huynh, Amit Agarwal, Vivek Gupta, Amit Desai, Rahul Singh, Prasanna Vibhute
Neuroradiology.2022; 64(12): 2409. CrossRef

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Getting Down to the Bare Bones: Does laminoplasty or laminectomy With Fusion Provide Better Outcomes for Patients With Multilevel Cervical Spondylotic Myelopathy?: Nolan J. Brown, Brian V. Lien, Shane Shahrestani, Elliot H. Choi, Katelynn Tran, Sandra Gattas, Seth C. Ransom, Ali R. Tafreshi, Ryan Chase Ransom, Ronald Sahyouni, Alvin Chan, Michael Oh; Neurospine 2021;18(1):45-54. Published online March 31, 2021; DOI: https://doi.org/10.14245/ns.2040520.260

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Getting Down to the Bare Bones: Does laminoplasty or laminectomy With Fusion Provide Better Outcomes for Patients With Multilevel Cervical Spondylotic Myelopathy?

Neurospine. 2021;18(1):45-54. Published online March 31, 2021

DOI: https://doi.org/10.14245/ns.2040520.260

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Getting Down to the Bare Bones: Does laminoplasty or laminectomy With Fusion Provide Better Outcomes for Patients With Multilevel Cervical Spondylotic Myelopathy?

Neurospine. 2021;18(1):45-54. Published online March 31, 2021

DOI: https://doi.org/10.14245/ns.2040520.260

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Objective
Cervical spondylotic myelopathy (CSM) is a degenerative disorder leading to progressive decline in spinal cord function. Cervical laminoplasty (CLP) and cervical laminectomy with fusion (CLF) are standard treatments for multilevel CSM. However, it is still unclear whether one procedure over the other provides better outcomes. Here, we performed a comprehensive review of published articles that compare the clinical outcomes and costs between CLP and CLF for CSM.
Methods
A literature search was performed using PubMed, Web of Science, and Cochrane databases. Strict exclusion criteria were applied, and included articles were then assessed for publication year, study design, and significant differences in outcome variables.
Results
From 519 studies identified with search terms, 38 studies were included for the qualitative analysis. Statistically significant differences in the clinical outcomes and costs were found in 18 studies. Eleven studies were prospective or retrospective, and 8 studies were meta-analyses. For the outcome variables of interest, results were reported by classifying into prospective studies, retrospective studies, and meta-analyses.
Conclusion
CLP and CLF are 2 of the most commonly performed surgical procedures for the treatment of CSM. Although CLP and CLF each provide satisfactory clinical outcomes for patients with CMS, CLP may result in better cervical range of motion and less cost, length of stay, operation time, blood loss, paraspinal muscular atrophy, and rate of nerve palsies as compared to CLF. The major limitation of CLP versus CLF comparison studies includes the heterogeneity in techniques and preoperative criteria. Thus, further validation and investigations in larger cohorts will be required.

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Laminoplasty vs Laminectomy and Fusion for Cervical Myelopathy: Alarming Rates of Bias
Henry Avetisian, Kevin Mathew, Annika Myers, Apurva Prasad, Jordan O. Gasho, William Karakash, Jeffrey C. Wang, Raymond J. Hah, Ram K. Alluri
Global Spine Journal.2026; 16(1): 297. CrossRef
Cervical Laminectomy for Degenerative Cervical Myelopathy: Is There A Role in the Modern Day? A Systematic Review and Meta-Analysis
Christopher S. Lozano, Armaan K. Malhotra, Husain Shakil, Vishwathsen Karthikeyan, Neevya Balasubramaniam, Uzondu Agochukwu, Ankit I. Mehta, Aditya Vedantam, C. Rory Goodwin, Nathan Evaniew, Aminul I. Ahmed, Ricardo Rodrigues-Pinto, Michael Fehlings, Jame
Global Spine Journal.2026;[Epub] CrossRef
Trends in laminoplasty versus posterior cervical fusion in the United States: a retrospective analysis from 2015 to 2023
Daniel Yusupov, Oscar Champigneulle, Matthew Johnson, Jacob S. Budin, Jorden Xavier, Leonidas E. Mastrokostas, Paul G. Mastrokostas, Arya Varthi, Alexander R. Vaccaro, Gregory D. Schroeder, Christopher K. Kepler, Jad Bou Monsef, Afshin E. Razi, Mitchell K
The Spine Journal.2026;[Epub] CrossRef
Comparative study between laminoplasty and laminectomy with or without fusion in cervical spondylotic myelopathy
Daniel Tama Boubane, Mohamed Abbas, Mostafa Elaskary, Ahmed Mohamed Khalil
Egyptian Journal of Neurosurgery.2026;[Epub] CrossRef
Biomechanical evaluation on a new type of vertebral titanium porous mini-plate and mechanical comparison between cervical open-door laminoplasty and laminectomy: a finite element analysis
Zhiwei Lin, Dongxin Lin, Lin Xu, Qiwei Chen, Manoj Kumar Vashisth, Xuecheng Huang, Yuping Deng, Feihu Zhang, Wenhua Huang
Frontiers in Bioengineering and Biotechnology.2024;[Epub] CrossRef
Comparative Biomechanical Stability of the Fixation of Different Miniplates in Restorative Laminoplasty after Laminectomy: A Finite Element Study
Guoyin Liu, Weiqian Huang, Nannan Leng, Peng He, Xin Li, Muliang Lin, Zhonghua Lian, Yong Wang, Jianmin Chen, Weihua Cai
Bioengineering.2024; 11(5): 519. CrossRef
Machine-learning-based models for the optimization of post-cervical spinal laminoplasty outpatient follow-up schedules
Yechan Seo, Seoi Jeong, Siyoung Lee, Tae-Shin Kim, Jun-Hoe Kim, Chun Kee Chung, Chang-Hyun Lee, John M. Rhee, Hyoun-Joong Kong, Chi Heon Kim
BMC Medical Informatics and Decision Making.2024;[Epub] CrossRef
An Observational Study Comparing Laminoplasty versus Lateral Mass Screw Fixation in Multilevel Cervical Compressive Myelopathy
R. Partha Sarathy, Sumit Bansal, Arunkumar Sekar, Ashis Patnaik, Rabi Narayan Sahu
Journal of Spinal Surgery.2024; 11(4): 134. CrossRef
Anterior and Posterior Approaches for 4-Level Degenerative Cervical Myelopathy: Low-Profile Cage Versus Cervical Pedicle Screws Fixation
Peng Zou, Rui Zhang, Jun-Song Yang, Er-Liang Li, Qian Zhang, Yuan-Ting Zhao
Journal of Clinical Medicine.2023; 12(2): 564. CrossRef
Nationwide sample data analysis of additional surgery rate after anterior or posterior cervical spinal surgery
Woon Tak Yuh, Minjung Kim, Yunhee Choi, Junghoon Han, Junhoe Kim, Taeshin Kim, Chun Kee Chung, Chang-Hyun Lee, Sung Bae Park, Kyoung-Tae Kim, John M. Rhee, Moon Soo Park, Chi Heon Kim
Scientific Reports.2023;[Epub] CrossRef
Biomechanical evaluation of reconstruction of the posterior complex in restorative laminoplasty with miniplates
Jianmin Chen, Guoyin Liu, Tianyi Bao, Yuansheng Xu, Hu Luo, Yu Wu, Dawei Cai, Feng Qin, Jianning Zhao
BMC Musculoskeletal Disorders.2023;[Epub] CrossRef
Developing Mixed-effects Models to Optimize Prediction of Postoperative Outcomes in a Modern Sample of Over 450,000 Patients Undergoing Elective Cervical Spine Fusion Surgery
Shane Shahrestani, Nolan J. Brown, John K. Yue, Lee A. Tan
Clinical Spine Surgery.2023; 36(10): E536. CrossRef

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Demographic Trends in Paddle Lead Spinal Cord Stimulator Placement: Private Insurance and Medicare Beneficiaries: Lawal Labaran, Joshua Bell, Varun Puvanesarajah, Nikhil Jain, Jomar N. Aryee, Micheal Raad, Amit Jain, Jonathan Carmouche, Hamid Hassanzadeh; Neurospine 2020;17(2):384-389. Published online February 1, 2020; DOI: https://doi.org/10.14245/ns.1938276.138

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Demographic Trends in Paddle Lead Spinal Cord Stimulator Placement: Private Insurance and Medicare Beneficiaries

Neurospine. 2020;17(2):384-389. Published online February 1, 2020

DOI: https://doi.org/10.14245/ns.1938276.138

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Demographic Trends in Paddle Lead Spinal Cord Stimulator Placement: Private Insurance and Medicare Beneficiaries

Neurospine. 2020;17(2):384-389. Published online February 1, 2020

DOI: https://doi.org/10.14245/ns.1938276.138

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Objective
Although spinal cord stimulators (SCS) continue to gain acceptance as a viable nonpharmacologic option for the treatment of chronic back pain, recent trends are not well established. The aim of this study was to evaluate recent overall demographic and regional trends in paddle lead SCS placement and to determine if differences in trends exist between private-payer and Medicare beneficiaries.
Methods
A retrospective review of Medicare and private-payer insurance records from 2007–2014 was performed to identify patients who underwent a primary paddle lead SCS placement via a laminectomy (CPT-63655). Each study cohort was queried to determine the annual rate of SCS placements and demographic characteristics. Yearly SCS implantation rates within the study cohorts were adjusted per 100,000 beneficiaries. A chi-square analysis was used to compare changes in annual rates.
Results
A total of 31,352 Medicare and 2,935 private-payer patients were identified from 2007 to 2014. Paddle lead SCS placements ranged from 5.9 to 17.5 (p<0.001), 1.9 to 5.9 (p<0.001), and 5.2 to 14.5 (p<0.001) placements per 100,000 Medicare, private-payer, and overall beneficiaries respectively from 2007 to 2014. SCS placements peaked in 2013 with 19.6, 7.1, and 16.8 placements per 100,000 Medicare, private-payer, and overall patients.
Conclusion
There was an overall increase in the annual rate of SCS placements from 2007 to 2014. Paddle lead SCS placements peaked in 2013 for Medicare, private-payer, and overall beneficiaries. The highest incidence of implantation was in the Southern region of the United States and among females. Yearly adjusted rates of SCSs were higher among Medicare patients at all time points.

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Military concerns for chronic pain stimulator devices
Scott Hughey, R Field, D Campbell, J Cole, G Booth, M Stringer, E Stedjelarsen
BMJ Military Health.2025; 171(1): 70. CrossRef
The Impact of Racial and Low Socioeconomic Status on the Implementation of Spinal Cord Stimulation for Chronic Pain in the United States
Gabriel Howard, Luis Guinand, Eric Xu, Alex Kervyn, Behnum Habibi
Current Pain and Headache Reports.2025;[Epub] CrossRef
Socioeconomic Determinants of Initiating Neuromodulation for Chronic Pain: A Systematic Review
Maarten Moens, Julie G. Pilitsis, Lawrence Poree, Yadeline Azurin, Maxime Billot, Manuel Roulaud, Philippe Rigoard, Lisa Goudman
Neuromodulation: Technology at the Neural Interface.2024; 27(8): 1266. CrossRef
Development of a Modified Bayonet Forceps for Improving Steerability of Paddle Lead Electrodes During Spinal Cord Stimulator Surgery: A Technical Note
Justin K. Zhang, Alborz Alimadadi, Mohammad Abolfotoh, Philippe Mercier, Tobias A. Mattei
Operative Neurosurgery.2023; 25(3): 285. CrossRef
Health Care Disparity in Pain
Travis M. Hamilton, Jared C. Reese, Ellen L. Air
Neurosurgery Clinics of North America.2022; 33(3): 251. CrossRef
Recent Trends in Medicare Utilization and Reimbursement for Spinal Cord Stimulators: 2000–2019
Marcus Romaniuk, Giyth Mahdi, Rohin Singh, Jack Haglin, Nolan J. Brown, Oren Gottfried
World Neurosurgery.2022; 166: e664. CrossRef
Erector Spinae Plane Catheter for Postoperative Thoracotomy Pain in a Patient With Indwelling Spinal Cord Stimulators: A Case Report
David T Cheng, Eldhose Abrahams, Aimee Pak
Cureus.2022;[Epub] CrossRef

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Recommendations of WFNS Spine Committee

Posterior Surgical Techniques for Cervical Spondylotic Myelopathy: WFNS Spine Committee Recommendations: Abdul Hafid Bajamal, Se-Hoon Kim, Mohammad Reza Arifianto, Muhammad Faris, Eko Agus Subagio, Ben Roitberg, Inyang Udo-Inyang, Jonathan Belding, Mehmet Zileli, Jutty K.B.C. Parthiban, World Federation of Neurosurgical Societies (WFNS) Spine Committee; Neurospine 2019;16(3):421-434. Published online September 30, 2019; DOI: https://doi.org/10.14245/ns.1938274.137

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Posterior Surgical Techniques for Cervical Spondylotic Myelopathy: WFNS Spine Committee Recommendations

Neurospine. 2019;16(3):421-434. Published online September 30, 2019

DOI: https://doi.org/10.14245/ns.1938274.137

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Posterior Surgical Techniques for Cervical Spondylotic Myelopathy: WFNS Spine Committee Recommendations

Neurospine. 2019;16(3):421-434. Published online September 30, 2019

DOI: https://doi.org/10.14245/ns.1938274.137

Close

Objective
This study was conducted to determine and recommend the most up-to-date information on the indications, complications, and outcomes of posterior surgical treatments for cervical spondylotic myelopathy (CSM) on the basis of a literature review.
Methods
A comprehensive literature search was performed, using the MEDLINE (PubMed), the Cochrane Register of Controlled Trials, and Web of Science databases, for peer-reviewed articles published in English during the last 10 years.
Results
Posterior techniques, which include laminectomy alone, laminectomy with fusion, and laminoplasty, are often used in patients with involvement of 3 or more levels. Posterior decompression for CSM is effective for improving patients’ neurological function. Complications resulting from posterior cervical spine surgery include injury to the spinal cord and nerve roots, complications related to posterior screw fixation or instrumentation, C5 palsy, spring-back closure of lamina, and postlaminectomy kyphosis.
Conclusion
It is necessary to consider multiple factors when deciding on the appropriate operation for a particular patient. Surgeons need to tailor preoperative discussions to ensure that patients are aware of these facts. Further research is needed on the cost-to-benefit analysis of various surgical approaches, the comparative efficacy of surgical approaches using various techniques, and long-term outcomes, as current knowledge is deficient in this regard.

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Kareem Khalifeh, Timothy Y Kim, Brian Hirshman, Martin Pham
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Rehabilitation strategies following posterior cervical decompression for cervical spondylotic myelopathy: a narrative review and framework for clinical practice
Kartik Akkhial, Aiyana Adams, Devender Singh, Matthew Geck, John Stokes, Eeric Truumees
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Patrick S. Rakotozanany, Ndalana A. Masina, Mijoro Ramarokoto, Willy Ratovondrainy
International Journal of Research in Medical Sciences.2026;[Epub] CrossRef
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Edward Goacher, Stefan Yardanov, Richard Phillips, Alexandru Budu, Edward Dyson, Marcel Ivanov, Gary Barton, Mike Hutton, Adrian Gardner, Nasir A. Quraishi, Gordan Grahovac, Josephine Jung, Andreas K. Demetriades, Pierluigi Vergara, Erlick Pereira, Vasile
British Journal of Neurosurgery.2025; 39(6): 776. CrossRef
Magnetic resonance spectroscopy in cervical spondylotic myelopathy: a systematic review of metabolite changes and clinical correlations
Iris Tatiana Montes-González, Dylan Paul Griswold, Fernando Peralta-Pizza, José Alberto Israel-Romero, Juan Felipe Mier-García, José Antonio Soriano-Sanchez
Frontiers in Medicine.2025;[Epub] CrossRef
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Francesco COSTA, Francesco RESTELLI, Elio MAZZAPICCHI, Emanuele RUBIU, Giulio BONOMO, Marco SCHIARITI, Niccolò INNOCENTI, Carla D. ANANIA, Andrea CARDIA, Maurizio FORNARI
Journal of Neurosurgical Sciences.2025;[Epub] CrossRef
Comparison of posterior approach surgical techniques for cervical spondylotic myelopathy: laminectomy with fusion, laminoplasty, and laminoplasty with fusion
Seung Hyeon Han, Sang Hyun Kim, Sung Hyun Noh, Jong Joo Lee, Yoon Ha, Pyung Goo Cho
The Spine Journal.2025; 25(11): 2413. CrossRef
Laminoplasty versus laminectomy for treatment of cervical spondylotic myelopathy: A randomized controlled Trial
Mohamed Salah Mohamed Ahmed Metwaly, Ahmed Mohamed Ezzat Abdel Fattah Mostafa, Ahmed Mohammed AlaaEldin Abd Elfattah Shalaby, Essam M. Youssef
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Giusy Guzzi, Riccardo Antonio Ricciuti, Attilio Della Torre, Erica Lo Turco, Angelo Lavano, Federico Longhini, Domenico La Torre
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A minimum data set—Core outcome set, core data elements, and core measurement set—For degenerative cervical myelopathy research (AO Spine RECODE DCM): A consensus study
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Egyptian Journal of Neurosurgery.2024;[Epub] CrossRef
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K. Arjun, P. K. Karthik Yelamarthy, T. V. Krishna Narayan, Ambadas Kathare, Raghav Dutt Mulukutla
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Endoscopic Treatment of Extraforaminal Entrapment of L5 Nerve Root (Far Out Syndrome) by Unilateral Biportal Endoscopic Approach: Technical Report and Preliminary Clinical Results: Dong Hwa Heo, Sagar Sharma, Choon Keun Park; Neurospine 2019;16(1):130-137. Published online March 31, 2019; DOI: https://doi.org/10.14245/ns.1938026.013

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Endoscopic Treatment of Extraforaminal Entrapment of L5 Nerve Root (Far Out Syndrome) by Unilateral Biportal Endoscopic Approach: Technical Report and Preliminary Clinical Results

Neurospine. 2019;16(1):130-137. Published online March 31, 2019

DOI: https://doi.org/10.14245/ns.1938026.013

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Endoscopic Treatment of Extraforaminal Entrapment of L5 Nerve Root (Far Out Syndrome) by Unilateral Biportal Endoscopic Approach: Technical Report and Preliminary Clinical Results

Neurospine. 2019;16(1):130-137. Published online March 31, 2019

DOI: https://doi.org/10.14245/ns.1938026.013

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Objective
Far out syndrome is compression and entrapment of the L5 nerve root in the extraforaminal area between the hypertrophied L5 transverse process and the sacral ala. The purpose of this study was to describe the technique of unilateral biportal endoscopic decompression for far out syndrome and to analyze early clinical results after endoscopic decompression.
Methods
The authors consecutively performed operative treatments for 16 patients with unilateral extraforaminal entrapment of the L5 nerve root (far out syndrome) using percutaneous biportal endoscopies. We included only patients who were followed more than six months after surgery. Demographic characteristics, operative time, concomitant herniated disc, and surgical complications were investigated. Clinical outcomes were evaluated using modified MacNab criteria, the visual analogue scale (VAS) for legs, and the Oswestry Disability Index (ODI).
Results
Among 16 patients, a total of 14 cases with 4 males and 10 females were included in the study. The mean leg VAS and the ODI were significantly improved after unilateral biportal endoscopic surgery. Concomitant extraforaminal disc herniation was associated with a favorable outcome (p<0.05). Abdominal pain in the immediate postoperative period occurred in 2 patients. Abdominal pain was completely resolved with conservative management in both patients.
Conclusion
We were able to achieve successful decompression of unilateral extraforaminal entrapment of the L5 nerve root using unilateral biportal endoscopic surgery. A unilateral biportal endoscopic approach may be considered as an alternative surgical treatment for far out syndrome.

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Long-term Clinical and Radiological Outcomes after Central Decompressive Laminoplasty for Lumbar Spinal Stenosis: Jun-Hwan Kim, Young-Joon Kwon; Korean J Spine 2017;14(3):71-76. Published online September 30, 2017; DOI: https://doi.org/10.14245/kjs.2017.14.3.71

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Long-term Clinical and Radiological Outcomes after Central Decompressive Laminoplasty for Lumbar Spinal Stenosis

Korean J Spine. 2017;14(3):71-76. Published online September 30, 2017

DOI: https://doi.org/10.14245/kjs.2017.14.3.71

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Long-term Clinical and Radiological Outcomes after Central Decompressive Laminoplasty for Lumbar Spinal Stenosis

Korean J Spine. 2017;14(3):71-76. Published online September 30, 2017

DOI: https://doi.org/10.14245/kjs.2017.14.3.71

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Objective:
There are many technical modifications of decompressive lumbar laminectomy. The purpose of this study was to report long-term clinical and radiological outcomes of central decompressive laminoplasty(CDL), the corresponding author’s own modification of lumbar laminectomy for lumbar spinal stenosis(LSS). Methods: Among 100 patients who underwent CDL by a single surgeon between December 2010 and March 2014, 68 patients were included in this study. Mean follow-up time was 37.7 months. Clinical and radiological data were gathered prospectively and reviewed retrospectively. Clinical outcome was measured by using visual analog scale(VAS) for back/buttock and leg, and the Oswestry Disability Index(ODI). Radiological outcome was measured by neutral slippage percentage, dynamic slippage percentage, and dynamic intervertebral angel on sagittal X-ray. Outcomes after CDL were assessed by changes of clinical and radiological parameters from the baseline. Mixed effect model with random patients’ effect as used to test for differences in the repeated measured clinical and radiological data. Results: The patients had no serious complications with an uneventful recovery during the early postoperative period. In the early postoperative period, VAS scores for back/buttock and leg improved significantly and were kept with time(p<0.001). ODI also improved significantly during the postoperative follow-up period(p<0.001). The radiologic parameters were well maintained and showed no progression of instability. During the follow-up, a case of herniated disc at same level recurrence was noted after lifting trauma, and 2 adjacent foraminal stenosis needed additional surgery. Conclusion: CDL provides long-term pain relief and functional restoration without progression of radiological instability.

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Jun Zhang, Tang-Fen Liu, Hua Shan, Zhong-Yuan Wan, Zhe Wang, Omar Viswanath, Antonella Paladini, Giustino Varrassi, Hai-Qiang Wang
Pain and Therapy.2021; 10(2): 941. CrossRef
Step-by-Step Sublaminar Approach With a Newly-Designed Spinal Endoscope for Unilateral-Approach Bilateral Decompression in Spinal Stenosis
Fujio Ito, Zenya Ito, Motohide Shibayama, Shu Nakamura, Minoru Yamada, Hideki Yoshimatu, Mikinobu Takeuchi, Kenzo Shimizu, Yasushi Miura
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Spine.2018; 43(24): 1756. CrossRef

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Single-Stage Operation for Giant Schwannoma at the Craniocervical Junction with Minimal Laminectomy: A Case Report and Literature Review: Sun Yoon, Hunho Park, Kyu-Sung Lee, Seoung Woo Park, Chang-Ki Hong; Korean J Spine 2016;13(3):173-175. Published online September 30, 2016; DOI: https://doi.org/10.14245/kjs.2016.13.3.173

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Single-Stage Operation for Giant Schwannoma at the Craniocervical Junction with Minimal Laminectomy: A Case Report and Literature Review

Korean J Spine. 2016;13(3):173-175. Published online September 30, 2016

DOI: https://doi.org/10.14245/kjs.2016.13.3.173

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Single-Stage Operation for Giant Schwannoma at the Craniocervical Junction with Minimal Laminectomy: A Case Report and Literature Review

Korean J Spine. 2016;13(3):173-175. Published online September 30, 2016

DOI: https://doi.org/10.14245/kjs.2016.13.3.173

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Here we report a single-stage operation we performed on a patient with a large schwannoma that extended from the lower clivus to the cervico-thoracic junction caudally. A number of authors have previously performed multilevel laminectomy to remove giant schwannomas that extend for considerable length. This technique has caused cervical instability such as kyphosis or gooseneck deformity on several occasions. We removed the tumor with a left lateral suboccipital craniectomy with laminectomy only at C1 and without any subsequent surgery-related neurologic deficits. However, this technique requires meticulous preoperative evaluation on existence of Cerebrospinal fluid (CSF) cleft between the tumor and spinal cord on magnetic resonance imaging, of tumor origin located at the upper cervical root, and of detachment of tumor from the origin site.

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Posterior Approach Resection of Giant Schwannomas at the Craniovertebral Junction: A Case Series
Glennie Ntsambi, Israël A Maoneo, Punga Ziko, Jean-Richard Kabongo, Simon Kutoloka, Chérubin Tshiunza, Larrey Kasereka Kamabu, Bienvenu Lebwaze, Raphael Chirimwami, Dieudonné Sanduku, Antoine Beltchika
Cureus.2025;[Epub] CrossRef
Long-segment intraspinal schwannomas resection: What is the minimum number of laminectomy levels required?
Zhiyu Xi, Li Jia, Yingfeng Wang, Qiyu Jia, Chengyu Xia, Jiang Liu
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Postlaminectomy Bilateral Lumbar Intraspinal Synovial Cysts: Sung Ik Cho, Jung Hwan Lee, Chung Kee Chough; Korean J Spine 2016;13(3):157-159. Published online September 30, 2016; DOI: https://doi.org/10.14245/kjs.2016.13.3.157

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Postlaminectomy Bilateral Lumbar Intraspinal Synovial Cysts

Korean J Spine. 2016;13(3):157-159. Published online September 30, 2016

DOI: https://doi.org/10.14245/kjs.2016.13.3.157

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Postlaminectomy Bilateral Lumbar Intraspinal Synovial Cysts

Korean J Spine. 2016;13(3):157-159. Published online September 30, 2016

DOI: https://doi.org/10.14245/kjs.2016.13.3.157

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Lumbar intraspinal synovial cysts are included in the difference diagnosis of lumbar radiculopathy. Developing imaging modalities has result in increased reporting about these lesions. However, the case of bilateral new lumbar intraspinal synovial cysts after laminectomy has been rarely reported. We report of a rare case with bilateral lumbar intraspinal synovial cysts after laminectomy, requiring surgical excision.

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Diagnostic challenge between hemorrhagic facet cyst and spontaneous spinal epidural hematoma: a case report and literature review
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Korean Journal of Spine.2017; 14(3): 93. CrossRef

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Rare Thoracolumbar Facet Synovial Cyst Presenting as Paraparesis: Anshul Dahuja, Gitanshu Dahuja, Rashmeet Kaur; Korean J Spine 2015;12(3):193-195. Published online September 30, 2015; DOI: https://doi.org/10.14245/kjs.2015.12.3.193

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Rare Thoracolumbar Facet Synovial Cyst Presenting as Paraparesis

Korean J Spine. 2015;12(3):193-195. Published online September 30, 2015

DOI: https://doi.org/10.14245/kjs.2015.12.3.193

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Rare Thoracolumbar Facet Synovial Cyst Presenting as Paraparesis

Korean J Spine. 2015;12(3):193-195. Published online September 30, 2015

DOI: https://doi.org/10.14245/kjs.2015.12.3.193

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Spinal cord compressing syndrome due to synovial cyst (SC) of the thoracolumbar spine is a rare clinical condition. In this report we aim to heighten awareness of the thoracolumbar facet synovial cyst as a possible cause of thoracic myelopathy. The SC was removed thoroughly by laminectomy. The patient had an excellent recovery. The etiological and therapeutic aspects are discussed.

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A Case Report of a Rare Cervical Synovial Cyst at the C7-T1 Level
Angel Parushev, Bogomil Iliev, Deyan Dzhenkov, Nadezhda Stefanova, Yanko G Yankov, Mustafa Ali, Yavor Enchev
Cureus.2025;[Epub] CrossRef
Synovial Cyst of Thoracic Spine: A Systematic Literature Review and Meta-Analysis
Prabin Shrestha, Satoshi Yamaguchi, Jangbo Lee, Hiroyuki Oya, Hiroto Kawasaki, Kirill V. Nourski, Matthew A. Howard, Patrick W. Hitchon
World Neurosurgery.2025; 202: 124385. CrossRef
Mid thoracic intra-spinal facet cyst with lumbar canal stenosis: a rare ‘double crush’
Abhinandan Reddy Mallepally, Nandan Marathe, Jeevan Kumar Sharma, Bibhudendu Mohaptra, Kalidutta Das
International Journal of Neuroscience.2023; 133(5): 567. CrossRef
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Bradley T Schmidt, Andrea L Strayer, James A Stadler
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Andrew Tompkins, Arjun Chandran, Christopher Lind, Alexandre Simonin
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BharatR Dave, Gayadhar Behera, Yash Shah, Ajay Krishnan
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Spinal synovial cysts. A case series and current treatment options
Konstantinos M. Themistoklis, Themistoklis I. Papasilekas, Konstantinos A. Boviatsis, Dimitrios A. Giakoumettis, Eustathios N. Vlachakis, Marios S. Themistocleous, Damianos E. Sakas, Stefanos I. Korfias
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Symptomatic Myelopathy Caused by Ossification of the Yellow Ligament: Dong Am Park, Seok Won Kim, Seung Myung Lee, Chong Gue Kim, Suk Jung Jang, Chang Il Ju; Korean J Spine 2012;9(4):348-351. Published online December 31, 2012; DOI: https://doi.org/10.14245/kjs.2012.9.4.348

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Symptomatic Myelopathy Caused by Ossification of the Yellow Ligament

Korean J Spine. 2012;9(4):348-351. Published online December 31, 2012

DOI: https://doi.org/10.14245/kjs.2012.9.4.348

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Symptomatic Myelopathy Caused by Ossification of the Yellow Ligament

Korean J Spine. 2012;9(4):348-351. Published online December 31, 2012

DOI: https://doi.org/10.14245/kjs.2012.9.4.348

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Objective

This study was performed to describe the clinical presentation, surgical outcome in patients with symptomatic myelopathy caused by ossification of the yellow ligament (OYL).

Methods

The authors reviewed consequent 12 patients in whom posterior decompressive laminectomies were performed for OYL from 1999 to 2005. Diagnostic imagings including simple radiographs, computed tomography and magnetic resonance images were performed in each case. The patients were reviewed to evaluate the clinical presentation, surgical outcome and complications of the operation.

Results

In all patients, OYL was located in the lower thoracic region and all patients presented with numbness on both limbs and pain. Among them, 5 patients presented with gait disturbance due to paraparesis and two patients had sphincter dysfunction. Decompressive laminectomy through a posterior approach using microscope resulted in improvement of symptoms in all patients, but, recovery was incomplete in a half of the patients. The mean postoperative Japanese orthopaedics association (JOA) score was 7.9 when compared with 4.9 in preoperative assessment and the mean recovery rate was 65%. Dural tear was noticed in four patients, so dural repair was performed, but there were no neurological deficits related to neural injury.

Conclusion

OYL is an uncommon cause of myelopathy but it can lead to debilitating thoracic myelopathy. Careful decompressive laminectomy can achieve favorable results.

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Rohit A. Thaker, Smit Kagathara, Pratik Shah
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Vit Kotheeranurak, Phattareeya Pholprajug, Guang-Xun Lin, Pritsanai Pruttikul, Wicharn Yingsakmongkol, Tawechai Tejapongvorachai, Jin-Sung Kim
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Xiaofei Hou, Zhongqiang Chen, Chuiguo Sun, Guangwu Zhang, Sijun Wu, Zheng Liu
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Nebiyu S. Osman, Zoe B. Cheung, Awais K. Hussain, Kevin Phan, Varun Arvind, Khushdeep S. Vig, Luilly Vargas, Jun S. Kim, Samuel Kang-Wook Cho
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Thoracic Ossification of the Ligamentum Flavum―Neuroradiologic and Pathologic Findings Based on Our Operative Experience and a Literature Review―
Misao Nishikawa, Takeshi Inoue, Hiroyuki Goto, Yusuke Kidosaki, Hideyuki Ohshige, Hiroki Ohata, Yuta Nakanishi, Atsufumi Nagahama, Hiroshi Uda, Hiromichi Ikuno
Spinal Surgery.2018; 32(2): 167. CrossRef
Clinical Results And Prognostic Factors for Thoracic Myelopathy Caused by Ossification of Yellow Ligament after Surgical Treatment
Whoan Jeang Kim, Dae Geon Song, Kun Young Park, Je Yun Koo, Won Cho Kwon, Kyung Hoon Park, Won Sik Choy
Journal of Korean Society of Spine Surgery.2014; 21(3): 116. CrossRef

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