Anterior spinal fusion versus laminoplasty for cervical spondylotic myelopathy: a retrospective review.
OBJECTIVE
To compare outcomes of anterior spinal fusion (ASF) versus laminoplasty for cervical spondylotic myelopathy (CSM).


METHODS
Records of 26 women and 37 men aged 34 to 83 (mean, 67) years who underwent ASF or laminoplasty for CSM were reviewed. Patient demographics, duration of symptoms, pre- and post-operative Japanese Orthopaedic Association (JOA) scores, Hirabayashi recovery rate, and radiographic features (including anteroposterior canal diameter, Pavlov ratio, and number of levels compressed) were compared.


RESULTS
The mean duration of symptoms was 9 months. The mean follow-up period was 40 months. Patients who underwent laminoplasty were older (p=0.015) and had more levels compressed (p<0.001) than those who underwent ASF. Patients with C3/4 compression were older than those without it (p=0.044). Younger patients had higher Hirabayashi recovery rate (p=0.043).


CONCLUSIONS
The surgical decision for ASF or laminoplasty mainly depends on the number of levels compressed and patient age. Laminoplasty is usually reserved for older patients with multiple level involvement. Age is the main predictive factor for surgical outcome.
Cheng
Sze-chung
SC
Department of Orthopaedics and Traumatology, Kwong Wah Hospital, Hong Kong. drandycheng@yahoo.com.hk
Yen
Chi-hung
CH
Kwok
Tik Koon
TK
Wong
Wing-cheung
WC
Mak
Kan-hing
KH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000473:pathology / Q000601:surgery*; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*; D055009:Spondylosis / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome