{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:40:37Z","timestamp":1753879237526,"version":"3.41.2"},"reference-count":17,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,6,8]],"date-time":"2025-06-08T00:00:00Z","timestamp":1749340800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100015083","name":"Peking University People's Hospital","doi-asserted-by":"publisher","award":["RDY2021\u201009","2023HQ05"],"award-info":[{"award-number":["RDY2021\u201009","2023HQ05"]}],"id":[{"id":"10.13039\/501100015083","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Titanium mini\u2010plates are applied in unilateral open\u2010door laminoplasty to secure the elevated laminae and prevent re\u2010closure. Whereas the conventional technique fixates every level, some surgeons plate only alternate levels to curb implant costs. Whether they could achieve similar long\u2010term clinical and radiographic efficacy is still questionable. This study aimed to compare the efficacy and safety of alternative\u2010level fixation versus all\u2010level fixation in cervical laminoplasty for multilevel cervical spondylotic myelopathy (CSM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis is conducted on 65 patients who underwent C3\u2013C7 unilateral laminoplasty at Peking University People's Hospital from July 2012 to December 2020. Patients are divided into two groups: alternative\u2010level fixation and all\u2010level fixation. Clinical outcomes, including operative time, intraoperative blood loss, postoperative hospitalization days, and complications, are assessed. The Japanese Orthopaedic Association (JOA) score is used for neurological function evaluation, while pain is assessed with the Visual Analog Scale (VAS). Radiographic outcomes include changes in anterior\u2013posterior diameter, Pavlov ratio, cervical lordosis (CL), thoracic slope (T1S), and sagittal vertical axis (SVA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both groups showed significant improvements in JOA (15.94\u2009\u00b1\u20090.85 vs. 8.74\u2009\u00b1\u20091.76 in alternative\u2010level and 16.1\u2009\u00b1\u20090.79 vs. 8.42\u2009\u00b1\u20091.84 in all\u2010level) and VAS (1.03\u2009\u00b1\u20090.87 vs. 5.79\u2009\u00b1\u20091.18 in alternative\u2010level, 1.06\u2009\u00b1\u20090.77 vs. 5.35\u2009\u00b1\u20091.17 in all\u2010level) postoperatively, with no statistically significant differences in clinical outcomes between the groups (JOA: 15.94\u2009\u00b1\u20090.85 vs. 16.1\u2009\u00b1\u20090.79, <jats:italic>p<\/jats:italic>\u2009=\u20090.394; VAS: 1.03\u2009\u00b1\u20090.87 vs. 1.06\u2009\u00b1\u20090.77, <jats:italic>p<\/jats:italic>\u2009=\u20090.432). Although total hospital costs are significantly lower in the alternative\u2010level fixation group (124,937\u2009\u00b1\u20095104.01 RMB vs. 88007.53\u2009\u00b1\u20097014.53, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), the all\u2010level fixation group demonstrated better long\u2010term preservation of APD (17.87\u2009\u00b1\u20090.60 vs. 17.50\u2009\u00b1\u20090.52) at the final follow\u2010up. Radiographic outcomes, including CL, T1s, and cSVA, show no significant differences between the two groups, indicating comparable spinal alignment outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Both all\u2010level and alternative\u2010level fixation methods effectively support the lamina and prevent reclosure, with significant improvement in clinical symptoms in both groups at the final follow\u2010up, showing no significant difference in postoperative clinical outcomes between the two. There are no differences in sagittal parameters. All\u2010level fixation method showed better preservation of the spinal canal diameter.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.70100","type":"journal-article","created":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T04:24:20Z","timestamp":1749443060000},"page":"2141-2149","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["All\u2010Level Versus Alternative\u2010Level in Unilateral Laminoplasty: A Retrospective Comparative Study"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6001-3071","authenticated-orcid":false,"given":"Bin","family":"Zheng","sequence":"first","affiliation":[{"name":"Spine Surgery Peking University People's Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenqi","family":"Zhu","sequence":"additional","affiliation":[{"name":"Spine Surgery Peking University People's Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Liang","sequence":"additional","affiliation":[{"name":"Spine Surgery Peking University People's Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4972-8719","authenticated-orcid":false,"given":"Haiying","family":"Liu","sequence":"additional","affiliation":[{"name":"Spine Surgery Peking University People's Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198310000-00003"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.bsd.0000091070.73042.23"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.bsd.0000095401.27687.c0"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-018-5533-0"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5413.144225"},{"issue":"1","key":"e_1_2_10_7_1","first-page":"E13","article-title":"Open\u2010Door Laminoplasty With Plate Fixation at Alternating Levels for Treatment of Multilevel Degenerative Cervical Disease","volume":"26","author":"Yang H.\u2010L.","year":"2013","journal-title":"Clinical Spine Surgery"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-024-07638-0"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-025-05491-y"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-016-3194-3"},{"key":"e_1_2_10_11_1","first-page":"144","article-title":"Open\u2010Door Cervical Laminoplasty Using Instrumentation of Every Level Versus Alternate Levels: A Multicenter, Randomized Controlled Trial","volume":"107","author":"Tamai K.","year":"2025","journal-title":"Journal of Bone and Joint Surgery. American Volume"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.3171\/2021.2.SPINE201955"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-016-4548-7"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nec.2017.09.019"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.05.060"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2022.102669"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2023.12.153"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-016-4524-2"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.70100","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T07:33:45Z","timestamp":1751441625000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.70100"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,8]]},"references-count":17,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1111\/os.70100"],"URL":"https:\/\/doi.org\/10.1111\/os.70100","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"type":"print","value":"1757-7853"},{"type":"electronic","value":"1757-7861"}],"subject":[],"published":{"date-parts":[[2025,6,8]]},"assertion":[{"value":"2025-02-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}