Image-guided resection for thoracic ossification of the ligamentum flavum

Object. The purpose of this study was to evaluate the advantages of using an image guidance system to aid in the resection of ossified of the ligamentum flavum (OLF) in the thoracic spine. The procedure and surgery-related outcome are discussed. Methods. Ten patients with myelopathy underwent laminotomy with medial facetectomy and an image guidance system was used to remove the OLF. No neurological deterioration occurred, and postoperative computerized tomography scanning demonstrated successful decompression and good preservation of the lateral parts of the facet joints. Conclusions. The image guidance system allows accurate resection of the OLF while preserving as much as possible the facet joints and posterior elements of the thoracic spine.