Comparison of staggered and conventional posterior single-door laminoplasty.

ABSTRACT

OBJECTIVE: This study aimed to delineate the clinical and radiological outcomes between two different single-door laminoplasty techniques, the staggered approach and the conventional one-sided approach, in treating cervical spondylotic myelopathy (CSM). METHODS: This is a retrospective chart review that involved 67 patients who had CSM with symptoms lasting for ≥3 months, and underwent staggered laminoplasty (Group A, n=35) or conventional laminoplasty (Group B, n=32). Outcomes measures included intraoperative parameters, the Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS) for pain, cervical curvature, cervical range of motion (ROM), and radiographic parameters that reflected the level of post-operative muscle atrophy. Follow-up assessments were available at 3-, 6-, and 12-months post-operation. RESULTS: The mean ages in Group A and Group B were 57.11 (SD, 8.02) and 55.28 (SD, 8.47) years, respectively, with a gender distribution of 40.00% female in Group A and 40.63% in Group B (P>0.05). The average operative times were 130.86 (SD, 11.80) and 129.84 (SD, 10.51) minutes, respectively (P>0.05). However, intraoperative blood loss in milliliters was significantly higher in Group A (196.06; SD, 32.69) compared to Group B (155.03; SD, 37.80) (P<0.001). JOA scores revealed no significant post-operative differences between the two groups. Nevertheless, Group A exhibited less VAS pain, reduced post-operative ROM loss at 6 and 12 months, and less alteration in cervical curvature and decreased severity in muscle atrophy at 3-, 6-, and 12-months post-surgery. CONCLUSION: Patients who underwent staggered single-door laminoplasty experienced more favorable outcomes in some metrics than those who received the conventional technique.