Clinical outcomes of modified versus traditional expansive open-door laminoplasty for cervical spondylotic myelopathy: A single-institution experience

Abstract

Purpose To compare the surgical outcomes of modified expansive open-door laminoplasty (EOL) (C4-C6) and traditional EOL (C3-C7) in patients with cervical spondylotic myelopathy (CSM). Methods One hundred and two CSM patients were retrospectively recruited from Fujian Medical University Union Hospital between March 2012 and December 2019. Seventy-one patients with CSM underwent modified EOL, and 31 patients underwent traditional EOL. The primary endpoint was axial symptoms. Results Patients who underwent modified EOL had a significantly lower incidence of axial symptoms (odds ratio: 0.273; 95% confidence interval: 0.184-0.691; p = .002). The length of hospital stay ( p = .263), and intraoperative blood loss ( p = .402) were not significantly different between the groups. Significantly more postoperative drainage was observed in patients who underwent modified EOL ( p < .001), while the cost of hospitalization in patients treated with traditional EOL was higher ( p = .011). There were significant differences between modified and traditional EOL for the changes in range of motion ( p < .001), modified Japanese Orthopaedic Association score ( p = .001), and the Nurick grade ( p = .014), while the changes of visual analogue scale ( p = .250), and the neck disability index ( p = .134) were not significantly different between the groups. Conclusion This study found modified EOL may decrease the incidence of axial symptoms in patients with CSM compared to traditional EOL.