C4-C5 cervical myelopathy

This video shows a single-port endoscopic cervical laminectomy performed on an 81-year-old patient with advanced cervical spondylotic myelopathy.

Clinical context.

The patient presented with:

• motor deficit in the upper limbs

• clumsiness of the hands

• balance disorders

• pyramidal spasticity

Imaging revealed arthritic spinal cord compression predominantly in the posterior region, centered at the C4-C5 level, causing severe narrowing of the cervical canal.

The indication was targeted posterior decompression of the cervical spine.

Technique: endoscopic laminectomy

Decompression was performed using single-port cervical spinal endoscopy through a sub-centimeter incision, allowing:

• high-definition exposure of the cervical canal

• Targeted laminectomy at C4-C5

• resection of posterior compressive arthritic elements

• Complete release of the spinal cord

This minimally invasive approach allows for effective decompression while limiting muscle damage, even in elderly patients.

Postoperative care

• Get up as soon as you return to your room

• Minimal post-operative pain

• Home delivery the next morning

• Start of physical therapy rehabilitation 15 days after surgery