• World Neurosurg · Nov 2019

    The Effect of Using Visual Trepan to Treat Single Segment Ossification of Ligamentum Flavum (OLF) under the Endoscope.

    • Wenjie Wu, Wenbo Diao, Sen Yang, Yang Guo, Ming Yan, and Fei Luo.
    • Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing, China.
    • World Neurosurg. 2019 Nov 1; 131: e550-e556.

    ObjectivesTo evaluate the surgical outcome of using a trepan to treat single-segment ossification of ligamentum flavum under endoscopy and the clinical value of the new surgical treatment.Materials And MethodsPatients who underwent surgery for single-segment ossification of ligamentum flavum from January 2015 to June 2018 were included in a retrospective analysis. Endoscopic visual trepan decompression was performed in 26 patients and posterior spinal canal resection and decompression was performed in 11 patients. Japanese Orthopaedic Association scores, Japanese Orthopaedic Association improvement rate, and visual analog scale scores of both groups were recorded during follow-up. Computed tomography was used to evaluate patients' residual area ratio of the vertebral canal. Operative time, length of stay, amount of bleeding, and hospital cost in both groups were recorded.ResultsAverage follow-up time was 8.9 ± 2.7 months. Average operative time was 100.6 ± 35.0 minutes in the experimental group and 140.5 ± 28.3 minutes in the control group. At the final follow-up, the average improvement rate of Japanese Orthopaedic Association score was 78.3% in the experimental group and 84.2% in the control group. The average residual area ratio of the vertebral canal, which was <50% before the operation in both groups, recovered to 100% in both groups after the operation. Visual analog scale score of all patients was significantly (P < 0.05) reduced at the final follow-up.ConclusionsThe visual trepan technique using a spinal endoscope can be used to treat single-segment ossification of ligamentum flavum. Advantages include less trauma, faster recovery, and lower cost. However, more cases and long-term follow-up are required to further evaluate the clinical effectiveness and safety of this surgical method.Copyright © 2019. Published by Elsevier Inc.

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