Long-Term Follow-Up After Cervical Laminectomy without Fusion for Cervical Spondylotic Myelopathy

OBJECTIVE: The objectives were to study the effect of cervical laminectomy without fusion on the incidence of further cervical surgeries, the risk for cervical misalign-ment, and current functional status. -METHODS: We retrospectively analyzed the clinical data of 340 patients who had undergone simple lam-inectomy for cervical spondylotic myelopathy (CSM) at Helsinki University Hospital between 2000 and 2011.RESULTS: Forty-one patients (12.1%) had later undergone another cervical surgery during the follow-up of a mean of 8.5 years (maximum, 17.5 years). The most common indi-cation for further surgery was residual stenosis at adjacent or other cervical levels (34%). Five patients (1%) required further surgery for correction of a sagittal balance problem. The mean Neck Disability Index was 28% at a median of 9.0 years after laminectomy. The mean EQ-5D (EuroQol 5 Dimension 3 Level) index score was 58.8 for patients and 77.2 for age-matched and gender-matched general popu-lation controls (P [ 0.000), indicating patients' reduced health-related quality of life. Worse preoperative condition in the Nurick score was related to a lower (i.e., worse) EQ-5D score. In an additional arm of the study with radio-graphic imaging (40 patients), the mean change in sagittal alignment was 4.0 degrees toward lordotic, and a newly developed kyphosis was found in 7.5% of patients.CONCLUSIONS: Because CSM is a serious degenerative progressive condition resulting in decreased health -related quality of life even after surgical treatment, the low rate of corrective surgery needed for alignment issues per se indicates that simple laminectomy can be a viable treatment option in treating multilevel CSM.

Automated summary

This study retrospectively analyzed the clinical data of 340 patients who underwent cervical laminectomy for cervical spondylotic myelopathy. The results showed that the rate of further cervical surgeries after laminectomy was low. The patients experienced decreased health-related quality of life, and some patients had cervical misalignments.