Laminoplasty with selective fusion at unstable segment versus laminectomy with fusion for multilevel cervical myelopathy: A retrospective comparative study

Abstract

Purpose The aim of this study was to compare laminoplasty with selective fixation (LPSF) versus laminectomy with fusion (LCF) in patients with multilevel cervical myelopathy accompanied by segmental instability.Methods A retrospective cohort study was conducted by reviewing data from 63 patients who underwent LPSF (n=30) or LCF (n=33). Cervical alignment, range of motion (ROM), neurologic status and axial symptom severity pre-operation, 3-days after operation, and at the final follow-up (minimum 24 months) were measured and compared between groups.Results Postoperation, patients in the LPSF group lost 31.1±17.3% of cervical lordosis and 43.2±10.9% cervical ROM while patients in the LCF group lost 5.7±8.2% and 67.9±15.5%, respectively. Both LPSF and LCF groups significantly improved neurologic status and axial symptom severity at the final follow-up with similar between-group results(P>0.05). Blood loss, operation time, hospital stay, and medical cost in the LPSF group were significantly less than in the LCF group(P<0.05). The incidence of negative events were statistically similar between groups.Conclusion According to our results, LPSF was effective in maintaining the stability of the cervical spine with less sacrifice of mobility and surgical trauma for multilevel myelopathy with segmental instability compared to LCF.