A comparison of clinical outcomes between percutaneous endoscopic laminectomy decompression and traditional laminectomy decompression in Thoracic Ossification of Ligamentum Flavum with CT classification of type unilateral segments.

Background: The aim of this study was to compare the effectiveness and safety of percutaneous endoscopic laminectomy decompression and traditional laminectomy decompression in the treatment of Thoracic Ossification of Ligamentum Flavum (T-OLF) with CT classification of type unilateral segments. Methods: We executed a retrospective study on 24 cases of T-OLF with CT classification of type unilateral segments between May 2015 and January 2018. All the patients were divided into two groups based on the relation to surgical methods. Patients in group A underwent percutaneous endoscopic laminectomy, and in group B underwent traditional laminectomy. According to the selection criteria, there were 10 patients in group A and 14 patients in group B. We mainly analyzed and compared the clinical, radiologic, perioperative outcomes, and surgery-related complications of the two groups of data. Results: Both groups improved significantly in the following projects：the JOA scores, mean JOA recovery rate, leg pain and radiologic results of decompression. However, no significant difference was found between the two groups. One case occurred dural tear in the early phase of percutaneous endoscopic laminectomy group. One patient occurred dural tear in during removal of OLF adhered to the dura mater in traditional laminectomy group. There were no cases of failure or recurrence in both groups. The percutaneous endoscopic laminectomy group have significant advantages in the following areas: back pain recovery, blood loss, hospital stay, hospitalization expenses and return-to-work. No post-laminectomy kyphosis was observed in any patients. Conclusions: Although percutaneous endoscopic laminectomy in thoracic region has a steep learning curve, percutaneous endoscopic laminectomy seemed to be an alternative surgical for T-OLF, type unilateral segments.