Global Spine Journal · IF 2.6 · August 7, 2026 · LoE III
Incidence of Tetraplegia After Cervical Laminectomy Versus Laminoplasty: A Propensity Score Matched Analysis Using US Collaborative Network Database in TriNetX
Teleale F. Gebeyehu, Yashvi Shah, Lucas Garmo, Alexander R. Vaccaro, Joshua Heller, Shaan Patel, Ashwini D. Sharan, Srinivas Prasad, Jack Jallo, James S. Harrop — Thomas Jefferson University
This retrospective database study used TriNetX to compare rates of postoperative tetraplegia between cervical laminectomy and laminoplasty in about 3,950 propensity-matched patients per group with degenerative cervical stenosis/spondylosis. Tetraplegia (almost always incomplete) was rare in both groups but occurred more often after laminectomy, especially at the C1-C4 level, where 12-month risk was 2.2% versus 1.1% with laminoplasty (OR 2.0, 95% CI 1.4-2.9); 12-month mortality was also higher after laminectomy (2.7% vs 1.6%, p=0.0004).
AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing
Why it mattersTetraplegia after posterior cervical decompression is a rare but catastrophic complication, and these real-world incidence estimates and procedure comparisons can inform how surgeons counsel patients when choosing between laminectomy and laminoplasty.
Conclusion strengthConfirms prior evidence
Registry cohort (adjusted): cannot support a practice change on its own.
Presenting this at rounds? Start here
- ?If laminectomy carries roughly double the risk of incomplete tetraplegia at C1-C4 compared to laminoplasty, should laminoplasty be preferentially considered for patients needing decompression at these upper cervical levels?
- ?Given the higher 12-month mortality seen with laminectomy in this cohort, how should surgeons weigh unmeasured confounding by indication (e.g., patients selected for laminectomy with fusion, frailty, or more severe disease) when counseling patients about procedure choice?