Comparative Utilization of Laminoplasty in the United States and Japan

Introduction: Laminoplasty is a well-established technique used to manage cervical myelopathy (CM). Nevertheless, the degree to which United States surgeons have adopted laminoplasty from Japan to treat CM is less clear. The purpose of this study was to compare operative management strategies for CM in the United States (US) with Japan.Methods: This study used a retrospective cohort of 16,084 patients from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database and 389,872 patients from the Japanese Diagnosis Procedure Combination (DPC) database from 2007 to 2015. Patients with the following diagnoses were collected: spondylosis with myelopathy (ICD-19; 721.1, ICD-10; M47.12) and disk herniation with myelopathy (ICD-9; 722.71, ICD-10; M50.00). The proportion of surgeries between Japan and the US was compared using a linear regression model controlling for year.Results: US surgeons utilized anterior procedures in 70% of cases compared to 9% in Japan (p