A recent study led by the co-chairman of the Spinal Program at the University of Toronto compared the results of receiving laminectomy plus spinal fusion to receiving just laminoplasty. In this international, multicenter study — which is part of an even larger study — researchers found that both types of surgery gave patients with cervical spondylotic myelopathy (CSM) significantly improved outcomes.
All of the patients involved in the study had a confirmed diagnosis of CSM, and their imaging results showed cord compression. The individual surgeons at the different centers determined which surgical technique was appropriate for each patient. In all, 108 patients underwent laminectomy and fusion, while 65 had laminoplasty. The researchers followed up with as many patients as possible one year after their procedures, giving them longitudinal data about 94 laminectomy plus fusion patients and 55 laminoplasty patients.
The two different groups of patients were roughly comparable in terms of average age and percent who were men versus women (each group was about 70% male). More of the laminectomy and fusion patients (roughly 24%) were smokers compared to the laminoplasty patients (17% smokers). In terms of pain and diagnostic assessments, the two groups mostly had relatively similar results. On one orthopaedic assessment scale, and in terms of the number of levels being operated on, the laminectomy and fusion patients were worse off.
Following the procedures, the laminectomy and fusion patients experienced more postoperative complications than the laminoplasty patients (23 patients in the former group, versus 7 in the latter). But both groups had statistically significant, similar improvements in all outcome measures 12 months following the procedures. In all, the patients who had laminectomy and fusion and the patients who had laminoplasty only had similar — and positive — results.
The lead researcher believes that given the roughly equal outcomes, patients with CSM should receive whichever treatment is best suited to their individual case. At the Spine Institute Northwest, minimally invasive laminoplasty performed with endoscopic magnification is an option for stenosis and myelopathy patients who do not have instability issues. This is distinctly different from anterior decompression, which is primarily a discectomy. If you are researching different procedures and looking for individualized treatment and direct contact with physicians, get in touch with the Spine Institute Northwest today!