A Randomized Controlled Trial Comparing Cervical Laminectomy with and without Intraoperative Neuromonitoring in Degenerative Cervical Myelopathy

Degenerative cervical myelopathy (DCM) is a common cause of spinal cord dysfunction requiring surgical decompression in patients with progressive neurological deficits. Posterior cervical laminectomy is widely used for multilevel disease and can be performed using either en bloc or piecemeal techniques. While en bloc laminectomy provides rapid decompression, it may result in sudden spinal cord expansion and intraoperative neuromonitoring changes. In contrast, piecemeal laminectomy allows gradual decompression and may reduce intraoperative neural stress.

There is limited prospective randomized evidence comparing these two techniques. This study is a single-center randomized controlled trial designed to compare intraoperative neuromonitoring responses (MEPs and SEPs), perioperative parameters, and clinical outcomes between en bloc and piecemeal laminectomy in patients with cervical spondylotic myelopathy.

A total of 100 patients will be enrolled and randomized into two groups. The primary outcome is intraoperative neuromonitoring changes, while secondary outcomes include neurological recovery (mJOA score), complications, operative time, and blood loss. The findings of this study aim to provide evidence to guide surgical decision-making and improve patient outcomes in cervical myelopathy.