Spine · IF 2.6 · July 20, 2026 · LoE II
Laminoplasty Associated With a Lower Risk of Reoperation Compared to Laminectomy/Fusion for Multilevel Posterior Cervical Spine Surgery
Alem Yacob, Heather A. Prentice, Amit Piple, Jessica Harris, Calvin C. Kuo, Elizabeth P. Norheim, Omid Hariri, Ehsan Tabaraee — Colorado Permanente Medical Group
This retrospective cohort study used a US multicenter spine registry to compare 1,294 patients who had posterior cervical laminoplasty (PCL) with 3,118 who had posterior cervical laminectomy and fusion (PLF) for multilevel cervical spondylosis. Over a median follow-up of 4.7 years, adjusted analyses showed PCL was associated with lower risk of reoperation for adjacent segment disease (HR 0.42, 95% CI 0.22-0.82) and lower risk of all-cause reoperation (HR 0.51, 95% CI 0.33-0.79), with no differences in mortality, 90-day ED visits, or 90-day readmissions.
AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing
Why it mattersThis is one of the largest comparative cohorts on posterior cervical decompression strategy and adds long-term reoperation data to an ongoing debate about laminoplasty versus laminectomy/fusion for multilevel cervical myelopathy.
Conclusion strengthPotentially practice-changing
The benefit exceeds a 25% relative reduction, though the 95% CI 0.22 to 0.82 reaches below it.
Presenting this at rounds? Start here
- ?Given the large imbalances in myelopathy diagnosis, spondylolisthesis, and number of levels between groups (SMD as high as 1.195), how confident can we be that multivariable adjustment fully accounted for confounding by indication in choosing PCL versus PLF?
- ?If your institution predominantly performs PLF for multilevel cervical spondylotic myelopathy, would this registry data alone be enough to shift your practice toward laminoplasty, or would you want patient-reported outcome and alignment data before changing technique?