In gratitude of the loyal support of our members, the CNS is offering complimentary 2021 Annual Meeting registration to all members! Learn more.

  • Comparison of Outcome Following Laminoplasty versus Laminectomy with Posterior Spinal Fusion for Cervical Spondylotic Myelopathy: Matched Cohorts Regional and Sagittal Balance

    Final Number:
    1234

    Authors:
    Darryl Lau MD; Praveen V. Mummaneni MD; Khoi Duc Than MD; Ethan A Winkler MD PhD

    Study Design:
    Other

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: The indications for laminoplasty and laminectomy with posterior spinal fusion are different for the treatment of cervical spondylotic myelopathy (CSM). Therefore, simple comparisons between the two techniques can be confounded. In this study, we compared outcomes of laminoplasty and laminectomy with posterior spinal fusion in cohorts of matched regional and sagittal balance.

    Methods: All adult patients from 2011 to 2013 undergoing laminoplasty or laminectomy with posterior spinal fusion for SCM were identified. A matched cohort was obtained by excluding laminectomy patients with regional Cobb angle and sagittal vertical axis measurements outside the range of laminoplasty patients. Preoperative, perioperative, and follow-up outcomes were compared.

    Results: A total of 42 laminoplasty patients and 26 laminectomy with fusion patients were included. Patients that underwent laminectomy tended to have less preoperative lordotic curvatures and higher VAS pain scores, but this was not significant (p=0.084 and p=0.067, respectively). Laminectomy with fusion was associated with significantly higher blood loss (356.0 ml vs. 231.0 ml, p=0.019). There was no difference in perioperative complication, length of stay, and 30-day readmission rate. Laminectomy with fusion was associated with higher long-term complications (15.4% vs. 0.0%, p=0.010), but had significantly lower mean Nurick myelopathy score at follow-up (0.8 vs. 1.6, p=0.020). Final Cobb and SVA were similar between the groups (matched).

    Conclusions: Laminectomy and fusion may be associated with higher morbidity than laminoplasty, but laminectomy with fusion may provide greater resolution of myelopathy. Additional matched cohort studies are warranted.

    Patient Care: The outcomes in this study may guide surgical decision making when counseling patients and recommending a particular procedure.

    Learning Objectives: By the conclusion of this session, participants should be able to: 1. Understand the differences in regards to perioperative and follow-up outcomes between laminoplasty and laminectomy with fusion.

    References:

We use cookies to improve the performance of our site, to analyze the traffic to our site, and to personalize your experience of the site. You can control cookies through your browser settings. Please find more information on the cookies used on our site. Privacy Policy