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Review
. 2016 Jun;95(23):e03588.
doi: 10.1097/MD.0000000000003588.

Laminoplasty versus laminectomy and fusion for multilevel cervical compressive myelopathy: A meta-analysis

Mengyue Huang  1 , Xuemei Gao  2 , Jingliang Cheng  1 , Jing Han  3 , Jingjing Liu  1
Affiliations
Review

Laminoplasty versus laminectomy and fusion for multilevel cervical compressive myelopathy: A meta-analysis

Mengyue Huang et al. Medicine (Baltimore). 2016 Jun.

Erratum in

  • Erratum: Medicine, Volume 95, Issue 23: Erratum.
    [No authors listed] [No authors listed] Medicine (Baltimore). 2016 Jul 18;95(28):e0916. doi: 10.1097/01.md.0000489580.04709.16. eCollection 2016 Jul. Medicine (Baltimore). 2016. PMID: 31265603 Free PMC article.

Abstract

This is a meta-analysis to compare the results between laminoplasty and laminectomy followed by fusion for the patients with multilevel cervical compressive myelopathy. An extensive search of literature was performed in MEDLINE, Embase, the Cochrane library, CNKI, and WANFANG. The following outcome measures were extracted: the Japanese Orthopaedic Association (JOA) scores, cervical curvature index (CCI), visual analog scale (VAS), cervical lordosis (C2-7), complications, blood loss, and operation time. Data analysis was conducted with RevMan 5.3 and STATA 12.0. A total of 23 studies comprising 774 and 743 patients treated with laminoplasty and laminectomy followed by fusion, respectively, were included in the final analysis. The pooled analysis showed that there was no significant difference in preoperative JOA scores [P = 0.89], postoperative JOA scores [P = 0.13], JOA scores improvement rate [P = 0.27], preoperative CCI [P = 0.15], postoperative CCI [P = 0.14], preoperative VAS [P = 0.41], postoperative VAS [P = 0.52], preoperative cervical lordosis (C2-7) [P = 0.46], postoperative cervical lordosis (C2-7) [P = 0.67], total complications [P = 0.07], axial pain [P = 0.94], and blood loss [P = 0.51]. However, there were significant difference in operation time (WMD = -19.57 [-32.11, -7.02], P = 0.002) and C5 palsy (OR = 0.26 [0.15, 0.44], P < 0.001). As compared with laminectomy followed by fusion, expansive laminoplasty showed no significant differences in JOA scores, CCI, ROM, VAS, cervical lordosis (C2-7), axial pain, total complications, and blood loss, but shorter operation time and fewer C5 palsy.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flow diagram of study selection.
Figure 2
Figure 2
The standardized mean difference (SMD) estimate for the preoperative JOA score. JOA, Japanese Orthopaedic Association.
Figure 3
Figure 3
The standardized mean difference (SMD) estimate for the postoperative JOA score. JOA, Japanese Orthopaedic Association.
Figure 4
Figure 4
The standardized mean difference (SMD) estimate for the JOA scores’ improvement rate. JOA, Japanese Orthopaedic Association.
Figure 5
Figure 5
The standardized mean difference (SMD) estimate for preoperative CCI. CCI, cervical curvature index.
Figure 6
Figure 6
The standardized mean difference (SMD) estimate for postoperative CCI. CCI, cervical curvature index.
Figure 7
Figure 7
The standardized mean difference (SMD) estimate for preoperative VAS. VAS, visual analog scale.
Figure 8
Figure 8
The standardized mean difference (SMD) estimate for postoperative VAS. VAS, visual analog scale.
Figure 9
Figure 9
The standardized mean difference (SMD) estimate for preoperative cervical lordosis (C2–7).
Figure 10
Figure 10
The standardized mean difference (SMD) estimate for postoperative cervical lordosis (C2–7).
Figure 11
Figure 11
The odds ratio (OR) estimate for total complications.
Figure 12
Figure 12
The odds ratio (OR) estimate for the C5 palsy.
Figure 13
Figure 13
The odds ratio (OR) estimate for the axial pain.
Figure 14
Figure 14
The standardized mean difference (SMD) estimate for blood loss.
Figure 15
Figure 15
The standardized mean difference (SMD) estimate for operation time.
Figure 16
Figure 16
X-ray radiographs of the patients. (1A) Cervical laminoplasty preoperatively; (1B) cervical laminoplasty 1 year after operation. (2A) Cervical laminectomy and fusion preoperatively; (2B) cervical laminectomy and fusion 1 year after operation.
See this image and copyright information in PMC

References

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