Vivien Chan, MD, MSc: No financial relationships to disclose
Introduction: The theoretical benefit of performing a cervical laminoplasty is to preserve motion while reducing risk of postoperative kyphosis associated with cervical laminectomies. However, there is a paucity of data comparing outcomes between cervical laminectomy without fusion and cervical laminoplasty. The purpose of this study was to compare the rate of conversion to cervical fusion between patients that received cervical laminectomy and cervical laminoplasty for degenerative cervical disease.
Methods: The PearlDiver database for years 2010 to 2021 was queried for patients who received a posterior cervical laminectomy or a cervical laminoplasty for a diagnosis of degenerative cervical disease. We excluded neoplastic, infectious, and traumatic etiologies. We excluded patients with previous cervical spine surgery, a diagnosis of cervical kyphosis, and less than 2 years of follow-up. Patient demographics were characterized using descriptive statistics. Rate of conversion to cervical fusion was determined for each cohort for 2-years, 5-years, and 10-years after surgery. The rates of conversion to cervical fusion between the two cohorts were compared using Chi-square test.
Results: A total of 4 916 patients were included in this study. Of the 4 916 patients, 2 514 received cervical laminectomy and 2 402 received cervical laminoplasty. In the cervical laminectomy cohort, 80.8% (n= 2 032) were 50 years of age or older. In the cervical laminoplasty cohort, 86.4% (n= 2 076) were 50 years of age or older. The rate of conversion to cervical fusion for patients who received cervical laminectomy at 2-years, 5-years, and 10-years after surgery were 4.2%, 6.5%, and 7.5%, respectively. The rate of conversion to cervical fusion for patients who received cervical laminoplasty at 2-years, 5-years, and 10-years after surgery were 3.3%, 4.7%, and 5.3%, respectively. There was no significant difference between the two groups at 2-years after surgery (p=0.1). Patients who received cervical laminectomy had a higher rate of conversion to fusion than cervical laminoplasty for 5-years (p=0.005), and 10-years (p=0.002) after surgery.
Conclusion : In patients with degenerative cervical disease, cervical laminectomy had a higher rate of conversion to cervical fusion than cervical laminoplasty at 5-years and 10-years post-surgery.