Clinical and functional outcomes of laminoplasty and laminectomy.
OBJECTIVE
Laminoplasty has become a common alternative to laminectomy for cervical spondylotic myelopathy or radiculopathy. The procedures have been compared before, but data on functional recovery are limited. We aim to compare the safety and short-term clinical and functional outcomes of cervical laminoplasty and cervical laminectomy.


METHODS
We performed a retrospective analysis of the outcome of 72 patients who had laminoplasty and 49 patients who had laminectomy at our hospital from 1999 to 2005. Patients had cervical spondylotic myelopathy or radiculopathy. All of the patients were similar in age and pre-operative functional status. All patients were assessed pre-operatively and 4 months post-operatively with the Rankin disability score, Glasgow outcome scale and Karnofsky and Nurick scales.


RESULTS
Laminoplasty resulted in greater improvement than laminectomy on the Rankin scale (p<0.0001, chi-square test), GOS (p<0.0027, chi-square test) and Karnofsky scores (p<0.01, Wilcoxon test). Nurick scores improved in both groups without a significant difference (p<0.62, Wilcoxon test). The proportion of patients who improved on all scales tended to be greater in the laminoplasty group. Patients spent 1.8 fewer days in the hospital after laminoplasty (p=0.04, Wilcoxon rank-sum test). There was no mortality or permanent morbidity for either procedure.


CONCLUSIONS
Both cervical laminectomy and laminoplasty are safe and effective for the treatment of cervical myelopathy or radiculopathy. Cervical laminoplasty results in a shorter hospital stay and greater functional improvement at 4 months follow-up.
Hardman
Julian
J
Department of Neurosurgery, School of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
Graf
Oliver
O
Kouloumberis
Pelagia E
PE
Gao
Wei-Hua
WH
Chan
Michael
M
Roitberg
Ben Z
BZ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000379:methods* / Q000706:statistics & numerical data; D008136:Longevity; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology; D011843:Radiculopathy / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D013115:Spinal Canal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D055009:Spondylosis / Q000601:surgery*; D016896:Treatment Outcome