Abstract: Objective  To investigate the efficacy and safety of rivaroxaban as prophylactic anticoagulant therapy after cervical expansive open-door laminoplasty in senior citizens. 
Methods  A retrospective study was performed on 87 patients aged ≥60 years who received posterior expansive open-door laminoplasty for cervical spine. The parients were divided into rivaroxaban group(n=47) and control group(n=40)  according to postoperative thrombosis prevention methods. Rivaroxaban group received rivaroxaban as anticoagulation therapy, while the control group did not receive anticoagulation therapy. Duration of operation, intraoperative blood loss, perioperative blood transfusion rate, incision drainage, postoperative hemorrhage, and incidence of venous thromboembolism(VTE) were compared between two groups. 
Results  There were no statistically significant differences in duration of operation, intraoperative blood loss, perioperative blood transfusion rate, postoperative drainage, and incidence of postoperative hemorrhage  between two groups(P＞0.05). The incidence of VTE in the rivaroxaban group was lower than that in the control group, with statistically significant differences(P＜0.05). 
Conclusion  Rivaroxaban significantly reduces the incidence of VTE after cervical expansive open-door laminoplasty in senior citizens, while avoiding the corresponding risk of bleeding. Therefore, rivaroxaban is a safe and reliable preventive anticoagulant after cervical expansive open-door laminoplasty.

Key words: cervical spine, expansive open-door laminoplasty, rivaroxaban