Laminectomy with fusion for cervical spondylotic myelopathy is associated with higher early morbidity and risk of perioperative complications compared with laminectomy alone: a retrospective study in the United States

作者：Abhinav K. Sharma, Paramveer Birring, Nischal Acharya, Manaav Mehta, Nicole Goldenhersh, Michael E. Steinhaus, Zorica Buser, Hao‐Hua Wu, Sohaib Hashmi, Don Young Park, Yu-Po Lee, Nitin Bhatia · 发表于：Asian Spine Journal · 年份：2025 · DOI：10.31616/asj.2024.0350 · 被引用次数：2 · 研究领域：Cervical and Thoracic Myelopathy、Spine and Intervertebral Disc Pathology、Scoliosis diagnosis and treatment

STUDY DESIGN: A retrospective cohort study. PURPOSE: We present data assessing the differences in 30-day morbidity, mortality, and postoperative complications between the two surgical remedy options. OVERVIEW OF LITERATURE: The choice between decompression with fusion or decompression alone for the management of cervical spondylotic myelopathy (CSM) remains controversial. METHODS: The American College of Surgeons National Quality Improvement Program database was queried for adults ≥18 years diagnosed with spondylosis with cervical myelopathy (10th revision of the International Classification of Diseases [ICD-10]: M47.12) or spinal stenosis of the cervical region (ICD-10: M48.02) who underwent laminectomy (Current Procedural Terminology [CPT] 63001, 63015, 63045) with or without fusion (CPT 22600) between 2015 and 2020. Patients were stratified into fusion and non-fusion cohorts for comparative review. Estimated 30-day mortality and morbidity, postoperative complications, and American Society of Anesthesiologists (ASA) classification were evaluated using chi-square and analysis of variance tests, and results were further stratified according to ASA classification. RESULTS: Of the 6,412 patients, 3,355 (52%) received laminectomy without fusion, and 3,057 (48%) experienced laminectomy with fusion. Patients undergoing decompression with fusion had higher mean morbidity (estimated probability 0.073 vs. 0.064, p<0.001), unplanned reoperations (4.2% vs. 2.7%, p<0.002), unplanned rea...