Learning Curve and Clinical Outcomes of Ultrasonic Osteotome-based En Bloc Laminectomy for Thoracic Ossification of the Ligamentum Flavum.

Initially, mastering the en bloc laminectomy technique using ultrasonic osteotome for TOLF treatment can be challenging, but the surgeon's experience improves as the operative time and blood loss decrease. Improved surgical experience reduced the risk of dural tears but was not associated with the overall complication rate or long-term neurological function. Despite the relatively long learning curve, en bloc laminectomy is a secure and valid technique for TOLF treatment.