[Objective]To explore the factors related to the clinical outcome of expansive open-door laminoplasty(ELAP)for treatment of multilevel cervical spondylotic myelopathy.[Methods]From July 2020 to June 2023,196 patients were treated with ELAP for multilevel cervical spondylotic myelopathy.Univariate comparison and binary multifactor logistic regression analysis were used to analyze the factors related to the recovery rate of neurological function.[Results]Of them,149 cases(76.0％ )got excellent recovery of nerve function with recov-ery rate of ≥50％ (the good group),whereas the remaining 47 cases(24.0％ )got recovery rate＜50％ (the poor group).In term of univariate comparison,the poor group proved significantly greater than the good group regarding to age[(62.2±8.8)years vs(56.3±10.2)years,P＜0.001],BMI[(27.0±2.9)kg/m2 vs(24.3±2.8)kg/m2,P＜0.001],hypertension ratio[cases(％ ),24(51.1)vs 32(21.5),P＜0.001],coronary heart disease[cases(％ ),11(23.4)vs 8(5.4),P＜0.001],smoking[y/n,(23/24)vs(37/112),P=0.002],and duration of disease[(14.9±15.1)months vs(10.3±10.8)months,P=0.022].As results of multivariate logistic regression,smoking(OR=6.406,P＜0.001),hypertension(OR=5.204,P=0.005),BMI(OR=1.396,P＜0.001),age(OR=1.075,P=0.034)were independent risk factors for poor neurological recovery after ELAP treat-ment in multi-segmental CSM.JOA score before surgery(OR=0.465,P＜0.01)and C2～7 Cobb angle 1 month after surgery(OR=0.841,P＜0.05)were protective factors for postoperative neurological recovery.[Conclusion]Age,BMI,history of hypertension,and smoking are inde-pendent risk factors for poor neurological recovery after ELAP treatment in multi-segmental CSM,while preoperative JOA score and C2～7 Cobb angle 1 month after surgery are protective factors for nerve recovery.
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