Asian Spine J.
2023 Jun;17(3):595-609. 10.31616/asj.2022.0184.
Laminoplasty versus Laminectomy in the Treatment of Primary Spinal Cord Tumors in Adult Patients: A Systematic Review and Meta-analysis of Observational Studies
- Byvaltsev V
1,2,3 - Polkin R1,2
- Kalinin A1,2
- Kravtsov M4,5
- Belykh E6
- Shepelev V1
- Satardinova E3
- Manukovsky V4,5
- Riew KD7,8
- Affiliations
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- 1Department of Neurosurgery, Irkutsk State Medical University, Irkutsk, Russia
- 2Department of Neurosurgery, Railway Clinical Hospital, Irkutsk, Russia
- 3Department of Traumatology, Orthopaedic and Neurosurgery, Irkutsk State Medical Academy of Postgraduate Education, Irkutsk, Russia
- 4Department of Neurosurgery, Saint-Petersburg I.I. Dzhanelidze Research Institute of Emergency Medicine, Saint Petersburg, Russia
- 5Department of Neurosurgery, North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russia
- 6Department of Neurosurgery, New Jersey Medical School, Rutgers University, Newark, NJ, USA
- 7Department of Orthopaedic Surgery, Columbia University, New York, NY, USA
- 8Department of Neurological Surgery, Weill Cornell Medical College, New York, NY, USA
- KMID: 2543166
- DOI: http://doi.org/10.31616/asj.2022.0184
Abstract
- The present systematic review and meta-analysis was conducted to compare the safety and efficacy of the two approaches for primary spinal cord tumors (PSCTs) in adult patients (laminoplasty [LP] vs. laminectomy [LE]). LE is one of the most common procedures for PSCTs. Despite advantages of LP, it is not yet widely used in the neurosurgical community worldwide. The efficacy of LP vs. LE remains controversial. Adult patients over 18 years of age with PSCT at the level of the cervical, thoracic, and lumbar spine were included in the study. A literature search was performed in MEDLINE via PubMed, EMBASE, The Cochrane Library, and Google Scholar up to December 2021. Operation time, hospital stay, complications, and incidence of postoperative spinal deformity (kyphosis or scoliosis were extracted. A total of seven retrospective observational studies with 540 patients were included. There were no significant differences between LP and LE group in operation time (p =0.25) and complications (p =0.48). The LE group showed larger postoperative spinal deformity rate than the LP group (odds ratio, 0.47; 95% confidence interval [CI], 0.27−0.84; p =0.01). The LP group had a shorter hospital stay (standardized mean differences, −0.68; 95% CI, −1.03 to −0.34; p =0.0001) than the LE group. Both LP and LE have comparable operative times and total complications in the treatment of PSCT. LP was superior to LE in hospital stay and postoperative spinal deformity rate. However, these findings are limited by the very low quality of the available evidence. Randomized controlled trials are needed for further comparison.
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