Surgical Outcome of Laminoplasty for Cervical Spondylotic Myelopathy in an Elderly Population – Potentiality for Effective Early Surgical Intervention: A Meta-analysis

摘要

A systematic review and meta-analysis was conducted to determine differences in surgical outcomes of laminoplasty for cervical spondylotic myelopathy (CSM) between elderly and non-elderly patients. PubMed and Google Scholar searches were performed using several key words and phrases related to cervical laminoplasty in elderly populations. Included studies were written in English, addressed laminoplasty for cervical spondylotic myelopathy, and evaluated outcomes of the treatment. Statistical analysis was performed using a random-effect model. The heterogeneity of the studies was assessed using Cochran’s Q statistic and I² statistic, and a funnel plot was constructed to evaluate publication bias. The search initially identified 255 articles on this topic. Nine clinical studies that met all inclusion criteria were included in the meta-analysis. A total of 1817 patients in these studies underwent cervical laminoplasty. Elderly patients had lower preoperative and postoperative Japanese Orthopedic Association (JOA) scores, and lower recovery rates based on JOA scores. Shorter operation times and reductions in intraoperative blood loss were found in the elderly group compared to the non-elderly group. The incidence of C5 palsy was not different between these groups. We here report the differences in surgical outcomes of laminoplasty for CSM through systematic review and meta-analysis. This report found poor surgical outcomes and lower preoperative JOA scores in elderly patients. Therefore, early surgical intervention may be recommended in elderly patients with CSM.