Cervical laminectomy and fusion versus laminoplasty in degenerative cervical myelopathy: A propensity score matching analysis.

Background: Degenerative cervical myelopathy (DCM) is a common cause of spinal cord dysfunction. The effectiveness of laminoplasty (LP) versus laminectomy with fusion (LF) for treating DCM is still debated. Here, we compared LP versus LF for treating DCM using propensity score matching (PSM) to minimize selection bias.

Methods: We identified DCM patients undergoing LP versus LF (2004-2022). Our analysis included demographics, preoperative/postoperative modified Japanese orthopedic association (mJOA) scoring, Visual Analog Scale (VAS) scores, assessment of postoperative cervical lordosis, operative time, blood loss, length of stay (LOS), and adverse events. PSM was performed to create balanced groups and minimize selection bias. Paired t-tests and Chi-square tests were used for statistical analysis.

Results: After PSM, 55 patients in each group were analyzed. LP patients had significantly shorter operative times and LOS, but VAS scores were significantly better for the LF group. Notably, both groups showed similar improvements in mJOA scores, frequency of intraoperative/postoperative adverse events, and reoperation rates. Although changes in cervical lordosis were significantly different between the groups, both groups showed comparable final lordotic curvatures.

Conclusion: LP procedures resulted in significantly shorter operative times and LOS, but VAS scores were correlated with significantly better outcomes in the LF group. Notably, both LP and LF patients demonstrated similar improvement in mJOA scores, frequencies of intraoperative/postoperative adverse events, and reoperation rates.