Outcomes after cervical laminectomy with instrumented fusion versus expansile laminoplasty: A propensity matched study of 3185 patients. Issue 3 (March 2015)

• Record Type: Journal Article
• Authors: Adogwa, Owoicho; Huang, Kevin; Hazzard, Matthew; Chagoya, Gustavo; Owens, Ryan; Cheng, Joseph; Ugiliweneza, Beatrice; Boakye, Maxwell; Lad, Shivanand P.
• Is Part Of: Journal of clinical neuroscience. Volume 22:Issue 3(2015:Mar.)
• Page Start: 549
• Page End: 553
• Publication Date: 2015-03
• Subjects: Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2014.10.001
• Languages: English
• ISSNs: 0967-5868

Abstract

<abstract xml:lang="en" abstract-type="author" id="ab005"> <title id="st100">Abstract</title> <sec> <p id="sp0005">The aim of this study was to compare reoperation, complication rates, and healthcare resource utilization of expansile laminectomies with instrumented fusion <italic>versus</italic> laminoplasty. Using the MarketScan database (Truven Health Analytics, Ann Arbor, MI, USA), we selected patients aged >18 years who underwent either cervical laminoplasty or laminectomy with fusion between 2000–2009. Propensity score modeling produced a matched cohort balanced for age, sex, comorbidities, and other relevant factors. A total of 3185 patients meeting our inclusion criteria also had 2 year follow-up available. Of these, 2927 (91.90%) and 258 (8.10%) had laminectomy with fusion and laminoplasty, respectively. Laminoplasty patients had significantly lower complication rates during index hospitalization (5.81 <italic>versus</italic> 9.62%, adjusted odds ratio [aOR]: 0.556, 95% confidence interval [CI]: 0.418–0.740, <italic>p</italic> < 0.0002), during 30 day (6.87 <italic>versus</italic> 11.12%, aOR: 0.568, 95% CI: 0.436–0.740, <italic>p</italic> < 0.0002) and 90 day (7.61 <italic>versus</italic> 11.78%, aOR: 0.593, 95% CI: 0.460–0.764, <italic>p</italic> < 0.0002) postoperative periods. They also had lower costs (United States dollars) during index hospitalization ($26, 129 <italic>versus</italic> $35, 483, <italic>p</italic> < 0.0004), and overall during the 2 year postoperative period ($77, 960 <italic>versus</italic> $106, 453, <italic>p</italic> < 0.0001). Two year reoperation rates were similar between both groups (9.77% <italic>versus</italic> 7.36%, <italic>p</italic> = 0.20). Our study suggests that cervical laminoplasty has significantly lower complication rates, similar long-term reoperation rates and lower healthcare resource utilization after 2 years than laminectomy with fusion.</p> </sec> </abstract>