STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To compare the short-term outcomes for patients undergoing cervical laminoplasty versus posterior decompression and fusion for multilevel cervical pathology. SUMMARY OF BACKGROUND DATA: There are conflicting data regarding the merits of cervical laminoplasty and posterior decompression and fusion for the treatment of multilevel cervical pathology. METHODS: Patients who underwent cervical laminoplasty or posterior decompression and fusion were identified in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2010 to 2012. Baseline patient characteristics were compared using bivariate logistic regression. Propensity-adjusted multivariate regressions were performed to assess differences in postoperative length of stay, adverse events, and 30-day readmission. RESULTS: A total of 779 patients were included in this study: 437 (56.1%) underwent cervical decompression and fusion and 342 (43.9%) underwent cervical laminoplasty. Decompression and fusion patients were found to be more comorbid at baseline than laminoplasty patients based on increased American Society of Anesthesiologists scores and Charlson Comorbidity Index.Propensity-adjusted multivariate analysis was used to control for differences in baseline patient characteristics, and found that compared with laminoplasty patients, decompression and fusion patients had increased length of stay (+1.2 d, P<0.001), greater rates of any adverse event (OR=1.7, P=0.018), and were more likely to be readmitted (OR=2.3, P=0.028). CONCLUSIONS: Posterior cervical decompression and fusion patients were found to have moderately worse short-term outcomes than laminoplasty patients. The information provided here can be used to inform patients and surgeons about the likely perioperative experience after they have made the decision to pursue 1 of these 2 procedures.
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To compare the short-term outcomes for patients undergoing cervical laminoplasty versus posterior decompression and fusion for multilevel cervical pathology. SUMMARY OF BACKGROUND DATA: There are conflicting data regarding the merits of cervical laminoplasty and posterior decompression and fusion for the treatment of multilevel cervical pathology. METHODS:Patients who underwent cervical laminoplasty or posterior decompression and fusion were identified in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2010 to 2012. Baseline patient characteristics were compared using bivariate logistic regression. Propensity-adjusted multivariate regressions were performed to assess differences in postoperative length of stay, adverse events, and 30-day readmission. RESULTS: A total of 779 patients were included in this study: 437 (56.1%) underwent cervical decompression and fusion and 342 (43.9%) underwent cervical laminoplasty. Decompression and fusion patients were found to be more comorbid at baseline than laminoplasty patients based on increased American Society of Anesthesiologists scores and Charlson Comorbidity Index.Propensity-adjusted multivariate analysis was used to control for differences in baseline patient characteristics, and found that compared with laminoplasty patients, decompression and fusion patients had increased length of stay (+1.2 d, P<0.001), greater rates of any adverse event (OR=1.7, P=0.018), and were more likely to be readmitted (OR=2.3, P=0.028). CONCLUSIONS: Posterior cervical decompression and fusion patients were found to have moderately worse short-term outcomes than laminoplasty patients. The information provided here can be used to inform patients and surgeons about the likely perioperative experience after they have made the decision to pursue 1 of these 2 procedures.
Authors: Samantha R Horn; Katherine E Pierce; Cheongeun Oh; Frank A Segreto; Max Egers; Cole Bortz; Dennis Vasquez-Montes; Renaud Lafage; Virginie Lafage; Shaleen Vira; Leah Steinmetz; David H Ge; John A Buza; John Moon; Bassel G Diebo; Haddy Alas; Avery E Brown; Nicholas A Shepard; Hamid Hassanzadeh; Peter G Passias Journal: Global Spine J Date: 2019-02-05
Authors: Fan Jiang; Jamie R F Wilson; Jetan H Badhiwala; Carlo Santaguida; Michael H Weber; Jefferson R Wilson; Michael G Fehlings Journal: Global Spine J Date: 2020-01-06
Authors: Christopher A Heid; Mitri K Khoury; Micah A Thornton; Tracy R Geoffrion; Alberto L De Hoyos Journal: Ann Thorac Surg Date: 2020-08-28 Impact factor: 5.102