At a Glance

• Cervical laminoplasty use declined among recent spine fellowship graduates.
• The number of surgeons performing the procedure remained stable.
• Training exposure and reimbursement may influence utilization trends.

Estimated read time: 2 minutes

A study presented at the AAOS 2026 Annual Meeting found that use of cervical laminoplasty among recent spine fellowship graduates declined steadily from 2004 to 2024 despite the procedure’s established role in treating cervical myelopathy and spinal cord compression.

Researchers performed a retrospective analysis of American Board of Orthopaedic Surgery (ABOS) Part II Oral Examination case submissions from 2004 to 2024. Surgeons submit all cases performed over a six‑month period, two years after fellowship completion. Cervical laminoplasty cases were identified using Current Procedural Terminology codes 63051 and 63050, and data such as practice region, patient age and gender, and surgeon‑reported postoperative outcomes (among others) were analyzed using descriptive statistics, Pearson’s chi‑squared test, and the Cochran-Armitage trend test.

The analysis included 744 patients with a mean age of 60.5 years and an average follow-up of 10.6 weeks; 61.8% were male. All surgeons performing cervical laminoplasty had completed a spine fellowship, with small proportions also completing adult reconstruction or pediatrics fellowships.

Usage varied by region, with the Southeast showing the highest proportion of cases (28.5%), followed by the Southwest (26.3%), Northwest (23.5%), Midwest (22%), Northeast (20.1%), and South (17.7%).

The proportion of cervical laminoplasty cases declined throughout the study period. Logistic regression demonstrated a 1.8% annual decrease in the odds of laminoplasty use (P = 0.014), whereas the number of surgeons performing the procedure remained unchanged over time (P = 0.982).

The most common indications for surgery were myelopathy, cervicalgia, and brachial neuritis. Reported postoperative surgical complications included nerve palsy (2.7%), infection (1.7%), and wound healing problems (1.3%), while urinary retention (0.9%) and delirium (0.7%) were the most frequent medical complications. Reoperation rates remained relatively stable over time (P = 0.32).

The authors suggested that variability in fellowship exposure and lower reimbursement compared with laminectomy and fusion with instrumentation may contribute to the declining trend. They emphasized the need to ensure adequate training and case exposure for future spine surgeons and noted that further work is needed to determine whether reimbursement adjustments could help support appropriate utilization of cervical laminoplasty.

The authors of “Trends in Cervical Laminoplasty Procedures Amongst American Board of Orthopaedic Surgery Part II Oral Examination Candidates: A 20-Year Analysis” are Theodore Quan, MD; Chukwuka Obiofuma, MD; Ruijie Yin, PhD; Lancelot Benn, MD; Seyed Babak Kalantar, MD, FAAOS; Zoher Ghogawala, MD; James D. Kang, MD, FAAOS; and Addisu Mesfin, MD, FAAOS.

Theresa Witham is the managing editor of AAOS Now.