Laminoplasty and laminectomy for cervical sponydylotic myelopathy: a systematic review

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• 作者：Ronald H. M. A. Bartels (1)
  Maurits W. van Tulder (2)
  Wouter A. Moojen (3)
  Mark P. Arts (5)
  Wilco C. Peul (4)
  
  1. Department of Neurosurgery ; Radboud University Nijmegen Medical Centre ; R. Postlaan 4 ; 6500 HB ; Nijmegen ; The Netherlands
  2. Department of Epidemiology and Biostatistics ; EMGO Institute for Health and Care Research ; VU University Medical Centre ; Amsterdam ; The Netherlands
  3. Department of Health Sciences ; Faculty of Earth and Life Sciences ; VU University ; Amsterdam ; The Netherlands
  5. Department of Neurosurgery ; Medical Center Haaglanden ; Lijnbaan 32 ; 2512 VA ; The Hague ; The Netherlands
  4. Department of Neurosurgery ; Leiden University Medical Center ; Albinusdreef 2 ; PO Box 9600 ; 2300 RC ; Leiden ; The Netherlands
  
• 关键词：Cervical spondylotic myelopathy ; Posterior approach ; Laminectomy ; Laminoplasty ; Systematic review
• 刊名：European Spine Journal
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：24
• 期：2-supp
• 页码：160-167
• 全文大小：200 KB
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgical Orthopedics
  Neurosurgery
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-0932

文摘

Background Cervical spondylotic myelopathy is frequently encountered in neurosurgical practice. The posterior surgical approach includes laminectomy and laminoplasty. Objective To perform a systematic review evaluating the effectiveness of posterior laminectomy compared with posterior laminoplasty for patients with cervical spondylotic myelopathy. Methods An extensive search of the literature in Pubmed, Embase, and Cochrane library was performed by an experienced librarian. Risk of bias was assessed by two authors independently. The quality of the studies was graded, and the following outcome measures were retrieved: pre- and postoperative (m)JOA, pre- and postoperative ROM, postoperative VAS neck pain, and Ishira cervical curvature index. If possible data were pooled, otherwise a weighted mean was calculated for each study and a range mentioned. Results All studies were of very low quality. Due to inadequate description of the data in most articles, pooling of the data was not possible. Qualitative interpretation of the data learned that there were no clinically important differences, except for the higher rate of procedure-related complications with laminoplasty. Conclusion Based on these results, a claim of superiority for laminoplasty or laminectomy was not justified. The higher number of procedure-related complications should be considered when laminoplasty is offered to a patient as a treatment option. A study of robust methodological design is warranted to provide objective data on the clinical effectiveness of both procedures.