Patient-reported outcomes following anterior cervical corpectomy and fusion versus laminectomy for degenerative cervical myelopathy: analyses of a national multicenter dataset.

PURPOSE: Evidence comparing anterior cervical corpectomy and fusion (ACCF) and laminectomy for degenerative cervical myelopathy (DCM), particularly regarding patient-reported outcome measures (PROMs), remains limited. This study compared postoperative PROMs, complication rates, and reoperation rates between ACCF and laminectomy in patients with DCM. METHODS: This retrospective study utilized prospectively collected registry data from the Swedish Spine Registry. All patients with DCM who underwent ACCF or laminectomy between 2006 and 2022 with available baseline and two-year European Myelopathy Score (EMS) data were identified. Complications and reoperations recorded in the registry were also assessed. EMS improvement at 2 years, postoperative complications, and reoperation rates were compared between the ACCF and laminectomy groups. Mixed-effects regression models were used to analyze factors associated with EMS improvement, complications, and reoperations. RESULTS: The ACCF and laminectomy groups included 248 and 498 patients, respectively. Both groups achieved comparable EMS improvements at 2 years (median +1 point). The laminectomy group had significantly fewer patient-reported complications than the ACCF group (odds ratio [OR]: 0.13, 95% confidence interval [CI]: 0.05-0.30, p < 0.01). Worse preoperative EMS was significantly associated with higher odds of patient-reported complications (OR: 0.79, 95% CI: 0.68-0.92, p < 0.01) and after-discharge reoperations (OR: 0.78, 95% CI: 0.65-0.95, p = 0.01). CONCLUSION: Laminectomy achieved comparable patient-reported myelopathy improvement with fewer complications than ACCF, supporting it as an effective option for appropriately selected patients with DCM.