ArticleJournal of orthopaedic surgery and research2026
Endoscopic posterior cervical canal decompression versus laminoplasty for two-level cervical spondylotic myelopathy: clinical outcomes and finite element analysis.
Article in Journal of orthopaedic surgery and research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo comprehensively evaluate the clinical efficacy, surgical invasiveness, learning curve, and biomechanical characteristics between endoscopic posterior cervical canal decompression (Endo-PCCD) and laminoplasty (LP) in patients with two-level cervical spondylotic myelopathy (CSM). This study uniquely integrates clinical outcomes, cumulative sum (CUSUM) learning curve analysis, and finite element modeling to provide a multidimensional comparison between the two procedures.
methodsThis retrospective study included 95 patients with CSM, of whom 45 underwent Endo-PCCD and 50 underwent LP. Baseline characteristics, perioperative parameters, and clinical outcomes (VAS, JOA, and NDI) were compared. DSA improvement rates were measured at C3-C5, C4-C6, and C5-C7 levels. Learning curves were assessed based on cumulative sum (CUSUM) analysis. Cervical finite element models were developed to evaluate the segmental range of motion (ROM) of Endo-PCCD and LP under identical loading conditions.
resultsBaseline characteristics were comparable between groups. The Endo-PCCD group showed significantly shorter operative time, lower drainage volume, and higher postoperative hemoglobin (Hb) levels (all P < 0.05). Clinical outcomes were similar at all follow-up time points. DSA improvement was significantly greater in the LP group at C5-C7 (P < 0.001), with no differences at other levels. Proficiency thresholds were 25 cases for Endo-PCCD and 19 cases for LP. Finite element analysis indicated that the LP model exhibited increased segmental ROM under flexion and extension, whereas the Endo-PCCD model maintained motion patterns closer to the intact spine.
conclusionEndo-PCCD achieves clinical outcomes comparable to LP while offering a potential trend toward reduced surgical invasiveness and may better preserve physiological cervical biomechanics, although LP may provide greater decompression at certain levels. Clinical trial number Not applicable.
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