The Orthobullets Podcast Podiums | Spine | RCT on A vs P for Myelopathy
Aug 22, 2025
Todd Albert, a leading expert and principal investigator at Jefferson, dives into a groundbreaking RCT comparing anterior vs posterior surgical approaches for cervical myelopathy. He discusses the impressive benefits of laminoplasty, emphasizing its potential for improved quality of life and fewer complications. Albert also shares insights on evolving laminoplasty techniques, highlighting crucial factors like graft sizes and patient selection. This conversation is a must-listen for anyone interested in innovative spinal surgery methods!
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Presenter's Personal Involvement
- Todd Albert disclosed he participated as a site PI and enrolled patients in the trial at Jefferson.
- He used the study to reevaluate and adopt laminoplasty more often in his practice.
Myelopathy Is A High-Priority Problem
- Cervical myelopathy has huge clinical and economic impact, prompting comparative effectiveness research priorities.
- The trial targeted a common clinical debate: anterior versus posterior surgical strategies for multilevel myelopathy.
Enforce Equipoise Before Randomization
- Use surgeon equipoise and a review panel when randomizing surgical approach to ensure appropriateness.
- Require a quorum and predefined thresholds before enrolling patients into randomized arms.