title: Laminoplasty versus laminectomy and fusion for multilevel cervical spondylotic myelopathy.
abstract: BACKGROUND
  Cervical spondylotic myelopathy is increasingly prevalent in the elderly and is the leading cause of spinal cord dysfunction in this population. Laminectomy with fusion and laminoplasty halt progression of myelopathy in these patients; however, both procedures have well-documented complications and associated morbidity and it is unclear which might be most advantageous.
  
  
  OBJECTIVE
  We therefore compared the pain, function and alignment of patients who underwent laminectomy with fusion to those with laminoplasty for the treatment of multilevel cervical spondylotic myelopathy.
  
  
  METHODS
  We performed a retrospective matched cohort analysis on all 121 patients from 2002 to 2007 who underwent laminectomy with fusion (82) or laminoplasty (39) for multilevel cervical spondylotic myelopathy. We determined change in preoperative and postoperative sagittal alignment using Cobb measurement, development of junctional stenosis, and subjective improvements in pain and gait. Complications were recorded for both cohorts.
  
  
  RESULTS
  The majority of patients in both cohorts reported improvements in pain and gait postoperatively. There were seven complications in the laminectomy and fusion cohort (9%) with two patients requiring formal revision surgery (2%). There were five complications in the laminoplasty cohort (13%) with two formal revision procedures (5%).
  
  
  CONCLUSIONS
  Patients in both the laminectomy with fusion and laminoplasty cohorts reported similar functional improvements after treatment for cervical spondylotic myelopathy. Prospective randomized control trials are needed to determine whether one procedure is truly superior.
  
  
  METHODS
  Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
authors.forename: Barrett I
authors.initials: BI
authors.lastname: Woods
authors.forename: Justin
authors.initials: J
authors.lastname: Hohl
authors.forename: Joon
authors.initials: J
authors.lastname: Lee
authors.forename: William
authors.initials: W
authors.lastname: Donaldson
authors.forename: James
authors.initials: J
authors.lastname: Kang
mesh_terms: D002574:Cervical Vertebrae / Q000601:surgery; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007796:Laminectomy / Q000379:methods*; D008141:Lordosis / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D011843:Radiculopathy / Q000150:complications / Q000601:surgery; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000150:complications / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013130:Spinal Stenosis / Q000150:complications / Q000601:surgery; D055009:Spondylosis / Q000150:complications / Q000601:surgery*