TY - JOUR
T1 - Outcomes after cervical laminectomy with instrumented fusion versus expansile laminoplasty
T2 - A propensity matched study of 3185 patients
AU - Adogwa, Owoicho
AU - Huang, Kevin
AU - Hazzard, Matthew
AU - Chagoya, Gustavo
AU - Owens, Ryan
AU - Cheng, Joseph
AU - Ugiliweneza, Beatrice
AU - Boakye, Maxwell
AU - Lad, Shivanand P.
N1 - Publisher Copyright:
© 2014 Elsevier Ltd.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - The aim of this study was to compare reoperation, complication rates, and healthcare resource utilization of expansile laminectomies with instrumented fusion versus 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 versus 9.62%, adjusted odds ratio [aOR]: 0.556, 95% confidence interval [CI]: 0.418-0.740, p < 0.0002), during 30 day (6.87 versus 11.12%, aOR: 0.568, 95% CI: 0.436-0.740, p < 0.0002) and 90 day (7.61 versus 11.78%, aOR: 0.593, 95% CI: 0.460-0.764, p < 0.0002) postoperative periods. They also had lower costs (United States dollars) during index hospitalization ($26,129 versus $35,483, p < 0.0004), and overall during the 2 year postoperative period ($77,960 versus $106,453, p < 0.0001). Two year reoperation rates were similar between both groups (9.77% versus 7.36%, p = 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.
AB - The aim of this study was to compare reoperation, complication rates, and healthcare resource utilization of expansile laminectomies with instrumented fusion versus 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 versus 9.62%, adjusted odds ratio [aOR]: 0.556, 95% confidence interval [CI]: 0.418-0.740, p < 0.0002), during 30 day (6.87 versus 11.12%, aOR: 0.568, 95% CI: 0.436-0.740, p < 0.0002) and 90 day (7.61 versus 11.78%, aOR: 0.593, 95% CI: 0.460-0.764, p < 0.0002) postoperative periods. They also had lower costs (United States dollars) during index hospitalization ($26,129 versus $35,483, p < 0.0004), and overall during the 2 year postoperative period ($77,960 versus $106,453, p < 0.0001). Two year reoperation rates were similar between both groups (9.77% versus 7.36%, p = 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.
KW - Cervical vertebrae
KW - Laminectomy
KW - Postoperative complications
KW - Reoperation
KW - Spinal fusion
KW - Treatment outcome
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U2 - 10.1016/j.jocn.2014.10.001
DO - 10.1016/j.jocn.2014.10.001
M3 - Article
C2 - 25515781
AN - SCOPUS:84923103539
SN - 0967-5868
VL - 22
SP - 549
EP - 553
JO - Journal of Clinical Neuroscience
JF - Journal of Clinical Neuroscience
IS - 3
ER -