Skip Laminectomy Compared with Laminoplasty for Cervical Compressive Myelopathy

World Neurosurg. (2018) 120:296-301

This meta-analysis evaluated the clinical outcomes of skip laminectomy relative to laminoplasty for the treatment of cervical compressive myelopathy.

METHODS: The Cochrane library, PubMed MEDLINE, EMBASE, and Web of Science databases were comprehensively searched to identify relevant articles published up to March 18, 2018. All values of weighted mean difference (WMD) or odds ratio are expressed as skip laminectomy relative to laminoplasty.

RESULTS: Four studies comprising 241 patients were included. Skip laminectomy and laminoplasty were comparable in terms of cervical lordotic curvature (weighted mean difference [WMD] L2.37; 95% confidence interval [CI] L6.18 to 1.43; P [ 0.22) and range of motion (WMD e2.65; 95% CI L6.02 to 0.72; P [ 0.12). The pooled data revealed that the mean visual analogue scale score for pain of the skip laminectomy group was significantly lower than that of the laminoplasty group (WMD e0.97; 95% CI L1.90 to L0.05; P [ 0.04), and the rate of axial pain was also significantly lower (WMD 0.26; 95% CI 0.07e0.93; P [ 0.04). The atrophy rates of the deep extensor muscles in the skip laminectomy group (14%) were significantly lower than that of the laminoplasty group (60%).

CONCLUSIONS: This meta-analysis determined that skip laminectomy was superior to laminoplasty in terms of visual analogue scale score and rates of axial pain and muscle atrophy. These results warrant further confirmation in future research.

Open-versus French-Door Laminoplasty for the Treatment of Cervical Multilevel Compressive Myelopathy: A Meta-Analysis

World Neurosurg. (2018) 117:129-136

OBJECTIVE: To compare the clinical outcomes and postoperative complications between open-door laminoplasty (ODL) versus French-door laminoplasty (FDL) for the treatment of cervical multilevel compressive myelopathy.

METHODS: We comprehensively searched PubMed, EMBASE, Cochrane library, and China National Knowledge Infrastructure to identify relevant articles. The search results were last updated on January 1, 2018. All values of weighted mean difference (WMD) and odds ratio are expressed as ODL relative to FDL.

RESULTS: Six studies containing 430 patients were included in our metaanalysis. In randomized controlled trials, there was no significant difference in Japanese Orthopaedic Association (JOA) scores between ODL and FDL groups (WMD, 0.06; 95% confidence limits [CL], e0.52 to 0.64; P [ 0.84). However, in the retrospective trials, JOA scores were significantly higher in the ODL group than in the FDL group (WMD, 0.95; 95% CL, 0.55e1.34; P < 0.05). The pooled data showed that the magnitude of spinal canal expansion in the ODL group was higher than in the FDL group (WMD, 24.39%; 95% confidence interval, 12.33e36.45; P < 0.05).

CONCLUSIONS: The present meta-analysis showed that the magnitude of canal expansion was higher with ODL than with FDL. There is a lack of compelling evidence to prove the superiority of one procedure over the other.