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Endoscopic techniques have gained attention as an alternative to open decompression. Two patients with bilateral lower-limb numbness and gait instability underwent streamlined navigated uniportal endoscopic decompression using only a single navigated instrument. Postoperative results showed complete decompression, minimal pain, short hospitalization, and neurological improvement with mJOA scores rising from 13 to 17 at 10 months.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/navigated-uniportal-endoscopic-decompression-for-thoracic-myelopathy-secondary-to-ossified-yellow-ligament-a-report-of-two-cases/438398/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/navigated-uniportal-endoscopic-decompression-for-thoracic-myelopathy-secondary-to-ossified-yellow-ligament-a-report-of-two-cases/438398.png","ImageObject",300,407,{"name":92,"@type":93},"dawugda","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-02","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What condition is addressed in the report and why is it important?","Question",{"text":113,"@type":114},"The report addresses thoracic myelopathy secondary to ossification of the yellow ligament (OYL), described as rare but potentially disabling because progressive calcification narrows the spinal canal and compresses the thoracic spinal cord.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was the navigated uniportal endoscopic decompression set up in these cases?",{"text":118,"@type":114},"A streamlined navigated uniportal approach was used with only one navigated instrument (a navigated burr). Intraoperative CT registration and real-time 3D guidance were used for level identification, trajectory planning, and visualization of the OYL margins.",{"name":120,"@type":111,"acceptedAnswer":121},"What outcomes were observed after surgery?",{"text":122,"@type":114},"Both cases showed complete decompression with minimal postoperative pain, short hospital stay, and neurological recovery. The mJOA score improved from 13 to 17 at 10 months.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},438398,1791287197,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},3985747870947,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Review began 11/14/2025  \nReview ended 12/01/2025  \nPublished 12/06/2025  \n© Copyright 2025  \nNg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98572  \nOpen Access Case Report  \nNavigated Uniportal Endoscopic Decompression for Thoracic Myelopathy Secondary to Ossified Yellow Ligament: A Report of Two Cases  \nBing Wui Ng 1, Ozlan Izma Muhamed Kamil 1  \n1. Department of Orthopaedics, Prince Court Medical Centre, Kuala Lumpur, MYS Corresponding author: Bing Wui Ng, [bingwuing@gmail.com](bingwuing@gmail.com)  \nAbstract  \nThoracic myelopathy secondary to ossification of the yellow ligament (OYL) is uncommon but potentially disabling. Endoscopic techniques have gained attention recently as an alternative to open decompression. We report two patients who suffered from thoracic myelopathy secondary to OYL managed using a streamlined setup of navigated uniportal endoscopic decompression utilizing only a single navigated instrument. Both patients presented with bilateral lower limb numbness and instability in walking, with a modified Japanese Orthopaedic Association (mJOA) score of 13 . Both cases post-operatively demonstrated complete decompression, minimal post-operative pain, short hospital stay, and neurological recovery with improvement in mJOA scores from 13 to 17 at 10 months. These cases highlighted the advantages ofthe combination of endoscope and navigation, which allowed easy identification of the pathological level, the ability to visualize the trajectory needed for decompression, which ensured adequacy of removal, while intraoperative CT could verify the complete decompression.  \nCategories: Neurology, Neurosurgery, Orthopedics  \nKeywords: endoscopic decompression, navigated endoscopy, ossified yellow ligament, thoracic myelopathy, uniportal endoscopy  \nIntroduction  \nThoracic myelopathy caused by ossification of the yellow ligament (OYL) is a rare but progressive condition leading to neurological compromise. This condition occurs when progressive calcification of the ligamentum flavum narrows the spinal canal and compresses the thoracic spinal cord, leading to chronic ischemia and neural dysfunction. Surgical decompression remains the standard of care [1,2]; however, open thoracic laminectomy is associated with significant morbidity due to extensive dissection of muscles and significant postoperative pain, leading to prolonged hospital stay.  \nFull-endoscopic techniques have demonstrated promising outcomes, with advantages including reduced blood loss, shorter hospital stays, and faster recovery compared to open surgery [3-5]. However, achieving adequate decompression or complete removal of the ossification through a limited corridor requires precise localization and control of the surgical field [6] .  \nIn recent years, navigation-assisted endoscopic techniques have been introduced to enhance surgical accuracy, especially in anatomically complex regions such as the thoracic spine [6] . The complexity of setups associated with navigation might deter surgeons from embarking on this technique. This report presents two cases of thoracic myelopathy secondary to OYL treated using a streamlined navigated uniportal endoscopic decompression technique and highlights its setup simplicity, clinical, and technical merits. To the best of our knowledge, we believe that this is the first report describing this setup and technique used inendoscopic thoracic surgery.  \nCase Presentation  \nCase 1  \nA 47-year-old female presented with a one-year history of gait instability and intermittent numbness in both lower limbs and trunk. She reported difficulty walking without support. Her modified Japanese Orthopaedic Association (mJOA) score was 13. MRI and CT demonstrated OYL at the T9-T11 levels.  \nUnder general anest","cbCaid7VMQjlGO8r","https://ap.wps.com/l/cbCaid7VMQjlGO8r","pdf",2333551,"English","# Abstract\n## Introduction\n## Case Presentation\n## Case 1","[{\"question\":\"What condition is addressed in the report and why is it important?\",\"answer\":\"The report addresses thoracic myelopathy secondary to ossification of the yellow ligament (OYL), described as rare but potentially disabling because progressive calcification narrows the spinal canal and compresses the thoracic spinal cord.\"},{\"question\":\"How was the navigated uniportal endoscopic decompression set up in these cases?\",\"answer\":\"A streamlined navigated uniportal approach was used with only one navigated instrument (a navigated burr). Intraoperative CT registration and real-time 3D guidance were used for level identification, trajectory planning, and visualization of the OYL margins.\"},{\"question\":\"What outcomes were observed after surgery?\",\"answer\":\"Both cases showed complete decompression with minimal postoperative pain, short hospital stay, and neurological recovery. The mJOA score improved from 13 to 17 at 10 months.\"}]","Navigated Uniportal Endoscopic Decompression for Thoracic Myelopathy Secondary to Ossified Yellow Ligament - A Report of Two Cases | PDF",1790685249,15]