RT Journal Article SR Electronic T1 Endoscopic Posterior Cervical Decompression for Ossified Posterior Longitudinal Ligament: A Technical Note JF International Journal of Spine Surgery JO Int J Spine Surg FD International Society for the Advancement of Spine Surgery SP 356 OP 363 DO 10.14444/8453 VO 17 IS 3 A1 Xifeng, Zhang A1 Zhang, Jiajing A1 Yan, Yuqiu A1 Bu, Rongqing A1 Fan, Haitao A1 Hagel, Vincent A1 Telfeian, Albert E. A1 Ramírez León, Jorge Felipe A1 Lorio, Morgan P. A1 Lewandrowski, Kai-Uwe YR 2023 UL https://www.ijssurgery.com/content/17/3/356.abstract AB Background Ossification of the posterior longitudinal ligament (OPLL) may cause cervical myelopathy. In its multilevel form, it may not be easy to manage. Minimally invasive endoscopic posterior cervical decompression may be an alternative to traditional laminectomy surgery.Methods Thirteen patients with multilevel OPLL and symptomatic cervical myelopathy were treated with endoscopic spine surgery from January 2019 to June 2020. In this consecutive observational cohort study, pre- and postoperative Japanese Orthopaedic Association (JOA) score and Neck Disability Index (NDI) were analyzed at a final follow-up of 2 years postoperatively.Results There were 13 patients consisting of 3 women and 10 men. The patient’s average age was 51.15 years. At the final 2-year follow-up, the JOA score improved from a preoperative value of 10.85 ± 2.91 to 14.77 ± 2.13 postoperatively (P < 0.001). The corresponding NDI scores decreased from 26.61 ± 12.88 to 11.12 ± 10.85 (P < 0.001). There were no infections, wound complications, or reoperations.Conclusion Direct posterior endoscopic decompression for multilevel OPLL is feasible in symptomatic patients when executed at a high skill level. While 2-year outcomes were encouraging and on par with historic data obtained with traditional laminectomy, future studies will need to show whether any long-term shortcomings exist.Level of Evidence 3.