Analysis of Short-Term Prognostic Factors of Posterior Single Open-Door Laminoplasty in Patients with Cervical Spondylotic Myelopathy.

Aim: Posterior cervical expansive open-door laminoplasty (ELAP) is one of the main methods for the treatment of multilevel cervical spondylotic myelopathy (CSM). However, some patients are vulnerable to developing complications such as kyphosis and axial symptoms after ELAP, potentially facing adverse prognosis following the procedure. At present, there are few reports on the short-term prognostic factors in Chinese patients with CSM after undergoing ELAP. The main objectives of this study are to investigate the efficacy of ELAP in the treatment of CSM and to analyze the short-term prognostic factors.

Methods: This study is a retrospective study. A total of 98 patients with CSM who received ELAP surgery in The First People's Hospital of Tongxiang City from May 2021 to October 2022 were selected as the study participants. The clinical efficacy of the ELAP was evaluated using visual analog scale (VAS), Japanese Orthopedic Association (JOA) score, and assessments based on imaging indicators. All patients were followed up for 1 year postoperatively. The short-term prognosis was analyzed according to JOA improvement rate, and the short-term prognostic factors were analyzed using multivariate logistic regression.

Results: The JOA scores of 98 CSM patients at 1 year after operation were significantly higher than those before operation (p < 0.001), and their postoperative VAS score were significantly lower than those before operation (p < 0.001). The postoperative cervical curvature (p < 0.001), sagittal diameter of cervical spinal canal (p < 0.001) and distance between vertebral body and posterior edge of spinal cord (p < 0.001) were significantly improved relative to the corresponding preoperative values. There was no significant difference in cervical 2-7 Cobb angle before and after operation (p = 0.979). Multivariate logistic regression analysis showed that age (p < 0.001), course of disease (p < 0.001) and preoperative JOA score (p < 0.001) were independent risk factors affecting the short-term prognosis in CSM patients.

Conclusions: ELAP is a safe and effective therapeutic approach for CSM, whose short-term prognosis is related to age, course of disease and preoperative JOA score.