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Getting Down to the Bare Bones: Does laminoplasty or laminectomy With Fusion Provide Better Outcomes for Patients With Multilevel Cervical Spondylotic Myelopathy?

Brown, Nolan J. and Lien, Brian V. and Shahrestani, Shane and Choi, Elliot H. and Tran, Katelynn and Gattas, Sandra and Ransom, Seth C. and Tafreshi, Ali R. and Ransom, Ryan Chase and Sahyouni, Ronald and Chan, Alvin and Oh, Michael (2021) Getting Down to the Bare Bones: Does laminoplasty or laminectomy With Fusion Provide Better Outcomes for Patients With Multilevel Cervical Spondylotic Myelopathy? Neurospine, 18 (1). pp. 45-54. ISSN 2586-6583. PMCID PMC8021836. doi:10.14245/ns.2040520.260.

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Objective. Cervical spondylotic myelopathy (CSM) is a degenerative disorder leading to progressive decline in spinal cord function. Cervical laminoplasty (CLP) and cervical laminectomy with fusion (CLF) are standard treatments for multilevel CSM. However, it is still unclear whether one procedure over the other provides better outcomes. Here, we performed a comprehensive review of published articles that compare the clinical outcomes and costs between CLP and CLF for CSM. Methods. A literature search was performed using PubMed, Web of Science, and Cochrane databases. Strict exclusion criteria were applied, and included articles were then assessed for publication year, study design, and significant differences in outcome variables. Results. From 519 studies identified with search terms, 38 studies were included for the qualitative analysis. Statistically significant differences in the clinical outcomes and costs were found in 18 studies. Eleven studies were prospective or retrospective, and 8 studies were meta-analyses. For the outcome variables of interest, results were reported by classifying into prospective studies, retrospective studies, and meta-analyses. Conclusion. CLP and CLF are 2 of the most commonly performed surgical procedures for the treatment of CSM. Although CLP and CLF each provide satisfactory clinical outcomes for patients with CMS, CLP may result in better cervical range of motion and less cost, length of stay, operation time, blood loss, paraspinal muscular atrophy, and rate of nerve palsies as compared to CLF. The major limitation of CLP versus CLF comparison studies includes the heterogeneity in techniques and preoperative criteria. Thus, further validation and investigations in larger cohorts will be required.

Item Type:Article
Related URLs:
URLURL TypeDescription CentralArticle
Brown, Nolan J.0000-0002-6025-346X
Lien, Brian V.0000-0003-3044-8626
Shahrestani, Shane0000-0001-7561-4590
Tran, Katelynn0000-0002-0593-8060
Ransom, Seth C.0000-0001-5949-1703
Tafreshi, Ali R.0000-0002-8956-3373
Sahyouni, Ronald0000-0002-2124-0535
Oh, Michael0000-0003-0477-6116
Additional Information:© 2021 by the Korean Spinal Neurosurgery Society. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Received August 25, 2020. Revised October 22, 2020. Accepted October 27, 2020. NJB, BVL, and SS contributed equally to this study as co-first authors. CONFLICT OF INTEREST. The authors have nothing to disclose.
Subject Keywords:Laminectomy, Spinal cord diseases, Laminoplasty, Cervical vertebrae
Issue or Number:1
PubMed Central ID:PMC8021836
Record Number:CaltechAUTHORS:20210527-093456879
Persistent URL:
Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:109274
Deposited By: George Porter
Deposited On:27 May 2021 21:18
Last Modified:16 Nov 2021 19:35

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