Comparison of Staggered and Conventional Posterior Single-Door Laminoplasty.

Abstract

This study aimed to delineate the clinical and radiological outcomes between 2 different single-door laminoplasty techniques, the staggered approach and the conventional one-sided approach, in treating cervical spondylotic myelopathy. This is a retrospective chart review that involved 67 patients who had cervical spondylotic myelopathy 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 score, visual analog scale for pain, cervical curvature, cervical range of motion, and radiographic parameters that reflected the level of postoperative muscle atrophy. Follow-up assessments were available at 3, 6, and 12 months postoperation. The mean ages in Group A and Group B were 57.11 (standard deviation [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). Japanese Orthopaedic Association scores revealed no significant postoperative differences between the 2 groups. Nevertheless, Group A exhibited less visual analog scale pain, reduced postoperative range of motion loss at 6 and 12 months, and less alteration in cervical curvature and decreased severity in muscle atrophy at 3, 6, and 12 months postsurgery. Patients who underwent staggered single-door laminoplasty experienced more favorable outcomes in some metrics than those who received the conventional technique.