Patients with myelopathy due to giant cTDH can be safely treated by the mini-thoracotomy approach. Postoperative neurological worsening and severe complications or incisional pain are rare. In contrast to complex posterior or thoracoscopic approaches, the mini-thoracotomy is technically straightforward and thus easy to learn for experienced spine surgeons.

We conclude that minimally invasive percutaneous fixation is a feasible and effective technique to achieve immediate pain release, avoid long-term immobilization and overcome the disadvantages of a dorsoventral procedure. However, surgical complications and possible follow-up procedures supplement the patients' risks of adverse reactions of the disease.

Highlights Focal cervical stenosis causes dynamic alterations across the entire cervical cord. Spinal cord tissue becomes object of stretching and compressive effects. Studying spinal cord motion provides information beyond anatomical imaging. Standardized data processing is the key to valid analysis of spinal cord motion.

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