This video demonstrates the step-by-step surgical technique for a less invasive cervical unilateral laminotomy for bilateral decompression (cervical ULBD). This technique allows surgeons to address bilateral cervical pathology while minimizing approach-related complications.¹ In the video, we present the case of a 72-yr-old female patient with a past medical history of C3-C4 anterior cervical discectomy and fusion who presented in clinic with persistent posterior spinal cord compression and signal change. The patient had bilateral hand numbness, weakness, poor dexterity, and a positive Hoffman's sign. The patient was treated via a C3-C4 less invasive cervical ULBD using a mobile 3-dimensional (3D) C-arm (Ziehm Vision RFD 3D®, Nürnberg, Germany) combined with 3D computer navigation. Patient consent was obtained prior to performing the procedure. Contrary to anterior techniques, posterior cervical approaches avoid potential dysphasia, recurrent laryngeal nerve injury, and adjacent segment degeneration. Furthermore, the less invasive cervical ULBD results in decreased pain and postoperative narcotic usage, shorter hospital stays and fewer infections compared to open approaches, as well as a lower risk for postlaminectomy kyphosis and deformity, since it requires less muscle disruption and bony removal. Additionally, the use of total 3D navigation facilitates the workflow and minimizes radiation exposure.

中文翻译：

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使用 3 维全导航通过单侧管状椎板切开术进行的无创宫颈减压术：2 维手术视频。

该视频演示了用于双侧减压（宫颈 ULBD）的侵入性较小的宫颈单侧椎板切开术的分步手术技术。这种技术使外科医生能够解决双侧宫颈病变，同时最大限度地减少与方法相关的并发症。¹在视频中，我们介绍了一名 72 岁女性患者的病例，她有 C3-C4 颈前路椎间盘切除术和融合的既往病史，在临床上表现为持续的后脊髓压迫和信号改变。患者双侧手麻木、无力、灵巧性差，霍夫曼征阳性。使用移动 3 维 (3D) C 臂（Ziehm Vision RFD 3D®，德国纽伦堡）结合 3D 计算机导航，通过 C3-C4 微创颈部 ULBD 对患者进行治疗。在执行该程序之前获得患者同意。与前路技术相反，后路颈椎入路可避免潜在的言语障碍、喉返神经损伤和邻近节段退变。此外，侵入性较小的宫颈 ULBD 可减少疼痛和术后麻醉剂的使用，与开放式方法相比，住院时间更短，感染更少，椎板切除术后后凸畸形和畸形的风险更低，因为它需要更少的肌肉破坏和骨质去除。此外，全 3D 导航的使用简化了工作流程并最大限度地减少了辐射暴露。