Laminoplasty versus skip laminectomy for the treatment of multilevel cervical spondylotic myelopathy: A systematic review

摘要

Introduction: Laminoplasty and skip laminectomy are two specific posterior surgical approaches for multilevel cervical spondylotic myelopathy. The objective of this study was to perform a systematic review comparing the clinical results and complications of laminoplasty and skip laminectomy in the treatment of multilevel cervical spondylotic myelopathy. Materials and methods: We reviewed and analyzed papers published from January 1969 to December 2012 through the Mediline, Embase, Cochrane review library, and other databases regarding the comparison between laminoplasty and skip laminectomy for multilevel cervical spondylotic myelopathy. Results: One randomized controlled trial and three non-randomized controlled trials were included in this systematic review. In three studies, the preoperative and postoperative JOA score was similar in both laminoplasty and skip laminectomy groups. In addition, for recovery rate, there was no significant difference between the groups. One study reported that, regarding SF12 scores, there was no significant difference in physical health and mental health after surgery. However, regarding cervical pain, the skip laminectomy group was better than the laminoplasty group significantly. No difference was presented in postoperative ROM and the cervical lordosis between the groups. But the ROM % (post/pre) was reported to be significantly better in the skip laminectomy group in three studies. Less blood loss and shorter operation time were observed in skip laminectomy rather than laminoplasty. Conclusions: Based on the results above, the skip laminectomy group presented better outcomes in a variety of aspects: ROM % (post/pre), complication rate, surgical trauma, etc. However, as limited study samples were included in the paper, a claim of superiority of the two approaches could not be justified. Further studies are required on the comparison between laminoplasty and skip laminectomy.