Abstract
Background
Biportal endoscopic spine surgery independently controls two hands, similar to microscopic surgery, and utilizes a broader working space that is not disturbed by retractors under clear-magnified endoscopic vision. These advantages facilitate successful neural decompression and safe transforaminal interbody fusion, even in patients with thoracic spondylotic myelopathy.
Methods
A wide laminectomy and precise total facetectomy, in conjunction with partial pediculotomy, establish a secure transforaminal space for cage insertion. Endplate preparation and cage insertion were performed without retracting the spinal cord under direct endoscopic vision.
Conclusion
Biportal endoscopic transforaminal thoracic interbody fusion can be a feasible technique for treating thoracic spondylotic myelopathy at the thoracolumbar junction levels.
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Data Availability
The data and materials used in this study are available upon request from the corresponding author.
Code Availability
Applicable.
References
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Corresponding author (SY Choi) conceived and designed the study, conducted data analysis and interpretation, drafted the manuscript, and critically reviewed it for important intellectual content.
First author (JY Kim) contributed to data collection, analysis, and interpretation, and critically reviewed the manuscript for important intellectual content.
Third author (KM Kim) contributed to study design, provided technical or material support, and critically reviewed the manuscript for important intellectual content.
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Supplementary information
Video 1. Intraoperative video of unilateral biportal endoscopic transforaminal thoracic interbody fusion at the T11-12 right. Procedures of bilateral decompression laminectomy using the over-the-top decompression technique. OLF: ossification of the ligamentum flavum. (MP4 88331 kb)
Video 2. Procedures of the laminotomy and facetectomy. IAP, inferior articular process; SAP, superior articular process. (MP4 52356 kb)
Video 3. Procedures of endplate preparation and cage insertion. DBM, demineralized bone matrix. (MP4 61171 kb)
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Kim, J.Y., Choi, S.Y. & Kim, K.M. Biportal endoscopic transforaminal thoracic interbody fusion for the treatment of thoracic myelopathy. Acta Neurochir 166, 134 (2024). https://doi.org/10.1007/s00701-024-06030-0
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DOI: https://doi.org/10.1007/s00701-024-06030-0