{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:11:45Z","timestamp":1783037505959,"version":"3.54.6"},"reference-count":30,"publisher":"Asian Spine Journal (ASJ)","issue":"4","license":[{"start":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:00:00Z","timestamp":1750723200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["asianspinejournal.org"],"crossmark-restriction":true},"short-container-title":["Asian Spine J"],"published-print":{"date-parts":[[2025,8,31]]},"abstract":"<jats:p>Study Design: A retrospective cohort study.Purpose: We present data assessing the differences in 30-day morbidity, mortality, and postoperative complications between the two surgical remedy options.Overview of Literature: The choice between decompression with fusion or decompression alone for the management of cervical spondylotic myelopathy (CSM) remains controversial.Methods: The American College of Surgeons National Quality Improvement Program database was queried for adults \u226518 years diagnosed with spondylosis with cervical myelopathy (10th revision of the International Classification of Diseases [ICD-10]: M47.12) or spinal stenosis of the cervical region (ICD-10: M48.02) who underwent laminectomy (Current Procedural Terminology [CPT] 63001, 63015, 63045) with or without fusion (CPT 22600) between 2015 and 2020. Patients were stratified into fusion and non-fusion cohorts for comparative review. Estimated 30-day mortality and morbidity, postoperative complications, and American Society of Anesthesiologists (ASA) classification were evaluated using chi-square and analysis of variance tests, and results were further stratified according to ASA classification.Results: Of the 6,412 patients, 3,355 (52%) received laminectomy without fusion, and 3,057 (48%) experienced laminectomy with fusion. Patients undergoing decompression with fusion had higher mean morbidity (estimated probability 0.073 vs. 0.064, p&lt;0.001), unplanned reoperations (4.2% vs. 2.7%, p&lt;0.002), unplanned readmissions (7.6% vs. 6.3%, p&lt;0.014), mean length of stay (5.0\u00b18.9 days vs. 3.4\u00b17.2 days, p&lt;0.001), deep wound infections (0.8% vs. 0.4%, p&lt;0.022), and bleeding risk necessitating transfusion (3.8% vs. 1.6%, p&lt;0.001). Stratification by ASA scores demonstrated an overall higher rate of 30-day postoperative complications with increasing ASA scores in both cohorts, However, the decompression with fusion cohort showed a greater relative increase in complications compared to the decompression-alone cohort with each ASA group.Conclusions: Decompression with fusion is correlated with higher estimated morbidity, unplanned reoperations and readmissions, and 30-day complications postoperatively. Decompression alone is an appealing procedure option for CSM, particularly for patients with higher ASA scores and those at greater risk.<\/jats:p>","DOI":"10.31616\/asj.2024.0350","type":"journal-article","created":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T02:00:32Z","timestamp":1750730432000},"page":"507-515","update-policy":"https:\/\/doi.org\/10.31616\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Laminectomy with fusion for cervical spondylotic myelopathy is associated with higher early morbidity and risk of perioperative complications compared with laminectomy alone: a retrospective study in the United 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