Comparison of Range of Motion Outcomes in Patients Undergoing Open-Door Laminoplasty or Posterior Cervical Fusion Surgery for Cervical Spondylotic Myelopathy

Aim: This study aimed to compare neurological and functional outcomes, including cervical range of motion (ROM), in patients with cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) who underwent either open-door laminoplasty (LP) or posterior cervical fusion (PCF) surgery. Material and Methods: This retrospective, single-center study included 38 patients, 11 female and 27 male, diagnosed with CSM and OPLL who underwent LP (n=20) or PCF (n=18) between 2014 and 2016. Clinical outcomes were assessed using the Japanese Orthopedic Association (JOA), visual analog scale (VAS), and Nurick scores. Cervical ROM values, including flexion, extension, lateral flexion, and rotation, were measured preoperatively and six months postoperatively in collaboration with physical therapy specialists. Results: Both LP and PCF groups showed significant postoperative improvement in JOA, VAS, and Nurick scores (all p<0.001), with no significant differences between groups (p=0.405, p=0.708, and p=0.963, respectively). Cervical ROM values significantly decreased in all directions postoperatively in both groups. Flexion (p<0.001), left lateral flexion (p=0.007), and left rotation (p=0.003) declined more severely in the PCF group, whereas the difference between groups did not reach statistical significance level in extension (p=0.105), right lateral flexion (p=0.065), and right rotation (p=0.067). Conclusion: LP and PCF offer similar neurological recovery in patients with CSM. However, LP better preserves postoperative cervical ROM. Despite the observed ROM reduction, daily functional activities remained largely unaffected. Long-term, larger studies are recommended for further validate these findings.