Outcomes after cervical laminectomy with instrumented fusion versus expansile laminoplasty: A propensity matched study of 3185 patients

Adogwa, Owoicho; Huang, Kevin T.; Hazzard, Matthew; Chagoya, Gustavo; Owens, Ryan; Cheng, Joseph; Ugiliweneza, Beatrice; Boakye, Maxwell; Lad, Shivanand P.

doi:10.1016/j.jocn.2014.10.001

Cited by 24 publications

(19 citation statements)

References 15 publications

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“…Nonetheless, reoperations rates were similar between the two groups and this is consistent with observations in a study by Adogwa et al, who reported reoperation rates of 10% in LPSF and 7% in laminoplasty patients. 1 Interestingly, in our cohort, patients who underwent LPSF were observed to have greater neurological improvement than patients who underwent laminoplasty at followup. The mean postoperative Nurick score for patients who underwent LPSF was 0.9 (no signs of myelopathy) and the mean Nurick score for laminoplasty patients was 1. neurological outcomes in patients who underwent laminoplasty or laminectomy for CSM, and they did not find a significant difference in follow-up JOA scale scores.…”

Section: Discussionmentioning

confidence: 61%

“…16 In regard to blood loss, our study showed a mean difference of 128.4 ml between the two groups; this difference is likely not clinically significant in adults. For the treatment of multilevel CSM, reported perioperative complication rates following laminoplasty range between 6% and 13%, 1,24,25 and for LPSF between 9% and 15%. 1,24,25 These rates are similar to what was observed in our study.…”

Section: Discussionmentioning

confidence: 99%

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Laminoplasty versus laminectomy with posterior spinal fusion for multilevel cervical spondylotic myelopathy: influence of cervical alignment on outcomes

Lau

Winkler

Than

et al. 2017

Journal of Neurosurgery: Spine

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OBJECTIVECervical curvature is an important factor when deciding between laminoplasty and laminectomy with posterior spinal fusion (LPSF) for cervical spondylotic myelopathy (CSM). This study compares outcomes following laminoplasty and LPSF in patients with matched postoperative cervical lordosis.METHODSAdults undergoing laminoplasty or LPSF for cervical CSM from 2011 to 2014 were identified. Matched cohorts were obtained by excluding LPSF patients with postoperative cervical Cobb angles outside the range of laminoplasty patients. Clinical outcomes and radiographic results were compared. A subgroup analysis of patients with and without preoperative pain was performed, and the effects of cervical curvature on pain outcomes were examined.RESULTSA total of 145 patients were included: 101 who underwent laminoplasty and 44 who underwent LPSF. Preoperative Nurick scale score, pain incidence, and visual analog scale (VAS) neck pain scores were similar between the two groups. Patients who underwent LPSF had significantly less preoperative cervical lordosis (5.8° vs 10.9°, p = 0.018). Preoperative and postoperative C2–7 sagittal vertical axis (SVA) and T-1 slope were similar between the two groups. Laminoplasty cases were associated with less blood loss (196.6 vs 325.0 ml, p < 0.001) and trended toward shorter hospital stays (3.5 vs 4.3 days, p = 0.054). The perioperative complication rate was 8.3%; there was no significant difference between the groups. LPSF was associated with a higher long-term complication rate (11.6% vs 2.2%, p = 0.036), with pseudarthrosis accounting for 3 of 5 complications in the LPSF group. Follow-up cervical Cobb angle was similar between the groups (8.8° vs 7.1°, p = 0.454). At final follow-up, LPSF had a significantly lower mean Nurick score (0.9 vs 1.4, p = 0.014). Among patients with preoperative neck pain, pain incidence (36.4% vs 31.3%, p = 0.629) and VAS neck pain (2.1 vs 1.8, p = 0.731) were similar between the groups. Similarly, in patients without preoperative pain, there was no significant difference in pain incidence (19.4% vs 18.2%, p = 0.926) and VAS neck pain (1.0 vs 1.1, p = 0.908). For laminoplasty, there was a significant trend for lower pain incidence (p = 0.010) and VAS neck pain (p = 0.004) with greater cervical lordosis, especially when greater than 20° (p = 0.011 and p = 0.018). Mean follow-up was 17.3 months.CONCLUSIONSFor patients with CSM, LPSF was associated with slightly greater blood loss and a higher long-term complication rate, but offered greater neurological improvement than laminoplasty. In cohorts of matched follow-up cervical sagittal alignment, pain outcomes were similar between laminoplasty and LPSF patients. However, among laminoplasty patients, greater cervical lordosis was associated with better pain outcomes, especially for lordosis greater than 20°. Cervical curvature (lordosis) should be considered as an important factor in pain outcomes following posterior decompression for multilevel CSM.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Laminoplasty versus laminectomy with posterior spinal fusion for multilevel cervical spondylotic myelopathy: influence of cervical alignment on outcomes

Lau

Winkler

Than

et al. 2017

Journal of Neurosurgery: Spine

View full text Add to dashboard Cite

show abstract

“…They found that the reoperation rate of cervical laminectomy with fusion and cervical laminoplasty over two-year follow-up was 9.77% and 7.36%, respectively. 11 This difference was not statistically significant. 11 While this serves as an interesting comparison between posterior procedures, they could not evaluate the difference between anterior and posterior procedures due to exclusion of patients who underwent anterior cervical surgical procedures.…”

Section: Discussionmentioning

confidence: 79%

“…10 Additionally, they did not compare the differences between reoperation rates in the early and late periods. 10 Adogwa et al 11 evaluated reoperation rates of cervical procedures using the MarketScan Database from 2000 to 2009. They found that the reoperation rate of cervical laminectomy with fusion and cervical laminoplasty over two-year follow-up was 9.77% and 7.36%, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Reoperation Rates After Surgery for Degenerative Cervical Spine Disease According to Different Surgical Procedures: National Population-based Cohort Study

Park

Moon

et al. 2016

Spine

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Development of personalized machine learning-based prediction models for short-term postoperative outcomes in patients undergoing cervical laminoplasty

Karabacak,

Margetis

2023

Eur Spine J

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Outcomes after cervical laminectomy with instrumented fusion versus expansile laminoplasty: A propensity matched study of 3185 patients

Cited by 24 publications

References 15 publications

Laminoplasty versus laminectomy with posterior spinal fusion for multilevel cervical spondylotic myelopathy: influence of cervical alignment on outcomes

Laminoplasty versus laminectomy with posterior spinal fusion for multilevel cervical spondylotic myelopathy: influence of cervical alignment on outcomes

Reoperation Rates After Surgery for Degenerative Cervical Spine Disease According to Different Surgical Procedures: National Population-based Cohort Study

Development of personalized machine learning-based prediction models for short-term postoperative outcomes in patients undergoing cervical laminoplasty

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