Abstract
Ossification of the posterior longitudinal ligament (OPLL) can lead to
cervical myelopathy, particularly in cases of multilevel involvement that pose
challenges for effective management. Minimally invasive endoscopic posterior cervical
decompression has emerged as a potential alternative to traditional laminectomy
surgery. In this chapter, the authors present their clinical experience and report on an
illustrative consecutive observational cohort study of thirteen patients with multilevel
OPLL and symptomatic cervical myelopathy. The Japanese Orthopaedic Association
(JOA) score and neck disability index (NDI) were assessed preoperatively and at a final
follow-up of two years postoperatively. The results demonstrated significant
improvements in the JOA score and NDI, indicating enhanced functional outcomes. No
infections, wound complications, or reoperations were reported. While the two-year
outcomes were promising and comparable to those achieved with traditional
laminectomy, further investigations are required to assess potential long-term
limitations.