Targeted Navigation-Guided Biportal Endoscopy for Thoracic Myelopathy Due to Disk-Osteophyte

Case: A 63-year-old man presented with progressive lower limb stiffness, weakness, and imbalance. Examination indicated thoracic myelopathy. Magnetic resonance imaging (MRI) and computed tomography (CT) revealed a left paracentral calcified disk-osteophyte complex at D10-D11 with cord edema. Navigation-assisted biportal endoscopic decompression with percutaneous stabilization was performed using the O-arm system. The patient regained mobility within 24 hours and had complete symptom resolution at 6 months. Conclusion: In complex thoracic pathologies, real-time navigation enhances the safety and accuracy of biportal endoscopy, allowing effective decompression and instrumentation with minimal invasiveness—highlighting its value in managing symptomatic thoracic disk herniations.