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Comparison of laminoplasty versus laminectomy and fusion in the treatment of multilevel cervical ossification of the posterior longitudinal ligament: A systematic review and meta-analysis.
Medicine (Baltimore). 2018 Jul; 97(29):e11542.M

Abstract

BACKGROUND

Laminoplasty (LP) and laminectomy with fusion (LF) were recognized as two reliable and effective way in treating multilevel cervical ossification of the posterior longitudinal ligament (OPLL). However, there was no clear conclusion on which method is better. A meta-analysis was conducted to evaluate the clinical results between LP and LF in the treatment of multilevel cervical OPLL.

METHODS

An extensive search of literature was performed in PubMed, Embase, the Cochrane library, CNKI (Chinese database), and WANFANG (Chinese database). The following outcomes were extracted: the Japanese Orthopedic Association (JOA) scores, visual analog scale (VAS), cervical lordosis, cervical range of motion (ROM), complications, blood loss, and operation time. Data analysis was conducted with RevMan 5.3.

RESULTS

A total of 11 studies were included in the final analysis. The results indicated that no significant differences between LP and LF group in terms of preoperative JOA scores (P = .58), postoperative JOA scores (P = .60), JOA scores improvement rate (P = 0.64), preoperative VAS (P = .34), postoperative VAS (P=.20), preoperative range of motion (ROM) (P = .10), postoperative ROM (P = .18), preoperative cervical lordosis (P = .56), C5 palsy (P = .16), and axial pain (P = .21). LF group showed larger postoperative cervical lordosis than LP group [standardized mean difference (SMD) = 1.13 (2.03, 0.24), P = .01]. However, LP group showed lower operation time [mean difference (MD) = 19.42 (26.87, 11.97), P < .001] and blood loss [MD = 94.78 (179.05, 10.51), P = .03] than LF group.

CONCLUSION

Both LP and LF can achieve clinical improvement in the treatment of multilevel cervical OPLL. LF was superior to LP in maintaining cervical lordosis. However, LP showed lower surgical trauma than LF. Kyphosis line (K-line) may be a good criterion in the selection of posterior surgery. LP was performed for the patients with K-line (+) and LF for K-line (-).

Authors+Show Affiliations

Department of Spine Surgery, The Third Hospital of Hebei Medical University Department of Spine Surgery, The Third Hospital of Shijiazhang Department of Endocrinology, The First Hospital of Shijiazhang Hebei Provincial Key Laboratory of Orthopedic Biomechanics, Shijiazhuang, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

30024545

Citation

Ma, Lei, et al. "Comparison of Laminoplasty Versus Laminectomy and Fusion in the Treatment of Multilevel Cervical Ossification of the Posterior Longitudinal Ligament: a Systematic Review and Meta-analysis." Medicine, vol. 97, no. 29, 2018, pp. e11542.
Ma L, Liu FY, Huo LS, et al. Comparison of laminoplasty versus laminectomy and fusion in the treatment of multilevel cervical ossification of the posterior longitudinal ligament: A systematic review and meta-analysis. Medicine (Baltimore). 2018;97(29):e11542.
Ma, L., Liu, F. Y., Huo, L. S., Zhao, Z. Q., Sun, X. Z., Li, F., & Ding, W. Y. (2018). Comparison of laminoplasty versus laminectomy and fusion in the treatment of multilevel cervical ossification of the posterior longitudinal ligament: A systematic review and meta-analysis. Medicine, 97(29), e11542. https://doi.org/10.1097/MD.0000000000011542
Ma L, et al. Comparison of Laminoplasty Versus Laminectomy and Fusion in the Treatment of Multilevel Cervical Ossification of the Posterior Longitudinal Ligament: a Systematic Review and Meta-analysis. Medicine (Baltimore). 2018;97(29):e11542. PubMed PMID: 30024545.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of laminoplasty versus laminectomy and fusion in the treatment of multilevel cervical ossification of the posterior longitudinal ligament: A systematic review and meta-analysis. AU - Ma,Lei, AU - Liu,Feng-Yu, AU - Huo,Li-Shuang, AU - Zhao,Zheng-Qi, AU - Sun,Xian-Ze, AU - Li,Feng, AU - Ding,Wen-Yuan, PY - 2018/7/20/entrez PY - 2018/7/20/pubmed PY - 2018/7/31/medline SP - e11542 EP - e11542 JF - Medicine JO - Medicine (Baltimore) VL - 97 IS - 29 N2 - BACKGROUND: Laminoplasty (LP) and laminectomy with fusion (LF) were recognized as two reliable and effective way in treating multilevel cervical ossification of the posterior longitudinal ligament (OPLL). However, there was no clear conclusion on which method is better. A meta-analysis was conducted to evaluate the clinical results between LP and LF in the treatment of multilevel cervical OPLL. METHODS: An extensive search of literature was performed in PubMed, Embase, the Cochrane library, CNKI (Chinese database), and WANFANG (Chinese database). The following outcomes were extracted: the Japanese Orthopedic Association (JOA) scores, visual analog scale (VAS), cervical lordosis, cervical range of motion (ROM), complications, blood loss, and operation time. Data analysis was conducted with RevMan 5.3. RESULTS: A total of 11 studies were included in the final analysis. The results indicated that no significant differences between LP and LF group in terms of preoperative JOA scores (P = .58), postoperative JOA scores (P = .60), JOA scores improvement rate (P = 0.64), preoperative VAS (P = .34), postoperative VAS (P=.20), preoperative range of motion (ROM) (P = .10), postoperative ROM (P = .18), preoperative cervical lordosis (P = .56), C5 palsy (P = .16), and axial pain (P = .21). LF group showed larger postoperative cervical lordosis than LP group [standardized mean difference (SMD) = 1.13 (2.03, 0.24), P = .01]. However, LP group showed lower operation time [mean difference (MD) = 19.42 (26.87, 11.97), P < .001] and blood loss [MD = 94.78 (179.05, 10.51), P = .03] than LF group. CONCLUSION: Both LP and LF can achieve clinical improvement in the treatment of multilevel cervical OPLL. LF was superior to LP in maintaining cervical lordosis. However, LP showed lower surgical trauma than LF. Kyphosis line (K-line) may be a good criterion in the selection of posterior surgery. LP was performed for the patients with K-line (+) and LF for K-line (-). SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/30024545/Comparison_of_laminoplasty_versus_laminectomy_and_fusion_in_the_treatment_of_multilevel_cervical_ossification_of_the_posterior_longitudinal_ligament:_A_systematic_review_and_meta_analysis_ L2 - https://doi.org/10.1097/MD.0000000000011542 DB - PRIME DP - Unbound Medicine ER -