2026 SICOT Annual Meeting: Noninferiority of alternate-level fixation compared with all-level fixation in open-door cervical laminoplasty: A multicenter randomized controlled trial

155 patients aged ≥60 years with degenerative cervical myelopathy undergoing C3–C6 open-door cervical laminoplasty were randomized to skip-fixation (n=80) or all-level fixation (n=75). The primary outcome of interest was the Japanese Orthopaedic Association (JOA) score at 2 years. Secondary outcomes included operative parameters, patient-reported outcomes, complications, and radiographic measures. Outcomes were assessed up to 2 years. Overall, the results of the study revealed that skip-fixation was noninferior to all-level fixation for neurological recovery and was associated with shorter operative time and greater improvement in several patient-reported outcomes. These findings suggest that alternate-level fixation may reduce surgical burden without compromising 2-year neurological outcomes.