Laminoplasty versus laminectomy with fusion for treating multilevel degenerative cervical myelopathy

Oussama Bakr, MS; Khadija Soufi, BS; Quincy Jones, BS; Barry Bautista, BS; Benjamin Van, MD; Zachary Booze, BS; Allan R. Martin, MD, PhD; Eric O. Klineberg, MD; Hai Le, MD; Julius O. Ebinu, MD, PhD; Kee D. Kim, MD; Yashar Javidan, MD; Rolando F. Roberto, MD

North American Spine Society Journal (Sep 2023)

Laminoplasty versus laminectomy with fusion for treating multilevel degenerative cervical myelopathy

Oussama Bakr, MS,
Khadija Soufi, BS,
Quincy Jones, BS,
Barry Bautista, BS,
Benjamin Van, MD,
Zachary Booze, BS,
Allan R. Martin, MD, PhD,
Eric O. Klineberg, MD,
Hai Le, MD,
Julius O. Ebinu, MD, PhD,
Kee D. Kim, MD,
Yashar Javidan, MD,
Rolando F. Roberto, MD

Affiliations

Oussama Bakr, MS: School of Medicine, University of California, Davis, CA, USA
Khadija Soufi, BS: School of Medicine, University of California, Davis, CA, USA
Quincy Jones, BS: School of Medicine, University of California, Davis, CA, USA
Barry Bautista, BS: School of Medicine, University of California, Davis, CA, USA
Benjamin Van, MD: School of Medicine, University of California, Davis, CA, USA
Zachary Booze, BS: School of Medicine, University of California, Davis, CA, USA
Allan R. Martin, MD, PhD: Department of Neurological Surgery, University of California, Davis, Sacramento, CA 95817, USA
Eric O. Klineberg, MD: Department of Orthopaedic Surgery, University of California, Davis, Sacramento, CA 95817, USA
Hai Le, MD: Department of Orthopaedic Surgery, University of California, Davis, Sacramento, CA 95817, USA
Julius O. Ebinu, MD, PhD: Department of Neurological Surgery, University of California, Davis, Sacramento, CA 95817, USA
Kee D. Kim, MD: Department of Neurological Surgery, University of California, Davis, Sacramento, CA 95817, USA
Yashar Javidan, MD: Department of Orthopaedic Surgery, University of California, Davis, Sacramento, CA 95817, USA
Rolando F. Roberto, MD: Department of Orthopaedic Surgery, University of California, Davis, Sacramento, CA 95817, USA; Corresponding author: Department of Orthopaedic Surgery, University of California, Davis, Sacramento, 4800 Y St #1700, Davis, Sacramento, CA 95817 USA.

Journal volume & issue: Vol. 15
p. 100232

Abstract

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Background: Laminectomy with fusion (LF) and laminoplasty (LP) are common posterior decompression procedures used to treat multilevel degenerative cervical myelopathy (DCM). There is debate on their relative efficacy and safety for treatment of DCM. The goal of this study is to examine outcomes and costs of LF and LP procedures for DCM. Methods: This is a retrospective review of adult patients (.05). Patients were successfully weaned off opioids at similar rates (LF: 88%, LP: 86%). Fixed and variable costs respectively with LF cases hospital were higher, 15.7% and 25.7% compared to LP cases (p=.03 and p<.001). LF has a longer length of stay (4.2 vs. 3.1 days, p=.001). Wound-related complications were 5 times more likely after LF (13.6% vs. 5.9%, RR: 5.15) and C5 palsy rates were similar across the groups (LF: 11.9% LP: 5.6% RR: 1.8). Ground-level falls requiring an emergency department visit were more likely after LF (11.9% vs. 2.6%, p=.04). Conclusions: When treating multilevel DCM, LP has similar rates of new or increasing axial neck pain compared to LF. LF was associated with greater hospital costs, length of stay, and complications compared to LP. LP may in fact be a less morbid and more cost-effective alternative to LF for patients without cervical deformity.

Published in North American Spine Society Journal

ISSN: 2666-5484 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery; Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry: Neurology. Diseases of the nervous system
Website: https://www.journals.elsevier.com/north-american-spine-society-journal-nassj/

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