Laminoplasty Versus Laminectomy With Fusion for Central Cord Syndrome: A Retrospective Comparative Analysis

Study Design: Retrospective cohort study. Objective: Compare short-term outcomes after cervical laminoplasty (LP) versus laminectomy with fusion (LF) for central cord syndrome (CCS). Background: CCS is the most common incomplete spinal cord injury. LP preserves motion and may reduce perioperative risk; LF is favored with instability or kyphosis. Large multicenter data can clarify early safety and utilization. Methods: Adults with CCS undergoing LP or LF were identified in the TriNetX Network. Cervical fracture, infection, and neoplasm were excluded. One-to-one propensity score matching on demographics and comorbidities created balanced cohorts (n=196 per group). Outcomes at 30, 60, and 90 days included health care utilization (readmission, emergency department/outpatient visits, physical therapy), medical complications, neurological events (sensory deficit, pain, gait abnormality, bowel/bladder dysfunction), and opioid exposure. Between-group differences were summarized as odds ratios (95% CI) with two-sided P values (α=0.05). Results: Among 1046 eligible patients (LF 811; LP 235), 196 per group were matched. Through 90 days, readmission, emergency department use, physical therapy, composite medical complications, neurological endpoints, and opioid exposure did not differ. Outpatient visits were higher at 30 days after LP (22.6% vs . 14.6%; P =0.030) but not at 60 or 90 days. Several infrequent surgical outcomes (hematoma, surgical-site infection, wound dehiscence, early implant failure, conversion to fusion, and revision subtypes) were not estimable because of small-cell suppression; dural tear/cerebrospinal fluid leak was 0 in both groups. Conclusions: LP and LF showed comparable short-term safety and utilization. Beyond a transient rise in 30-day outpatient visits after LP, no meaningful differences—including opioid exposure—were observed. LP is a reasonable short-term alternative to LF for selected CCS patients. Longer follow-up is needed to assess rare device-related events.