Clinical outcomes of laminoplasty versus laminectomy for intraspinal tumor: A meta-analysis

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Objective To assess the efficacy and safety of laminoplasty (LAMP) versus laminectomy (LAMT) in the treatment of intraspinal tumors. Methods We searched the databases (PubMed, EMbase, the Cochrane Library, CBM, CNKI and Wanfang) to search randomized controlled trials (RCTs) or non-randomized controlled clinical trials (non-RCTs). There was no restriction on publication time. The quality of the included trials was assessed and meta-analysis was conducted by RevMan 5.3 software. Results A total of 14 studies (1 RCT and 13 non-RCTs) involving 1 089 patients were included. Meta-analysis results showed that LAMP increased the effective recovery rate [88.3% (128/145) vs. 71.6% (68/95), P=0.002] and reduced the blood loss (SMD=-3.50, 95%CI: -4.84 to -2.16, P<0.01) when compared with LAMT. Meanwhile, the incidences of spinal deformity [6.1% (19/313) vs. 28.9% (153/529), P<0.01], spinal instability [2.5% (7/279) vs. 31.3% (81/259), P<0.01] and cerebrospinal fluid leak [3.0% (10/330) vs. 11.7% (64/548), P<0.01] in LAMP group were lower than those in LAMT group. However, there was no significant difference in total resection rate of tumor [87.1% (183/210) vs. 75.4% (239/317), P=0.21], operation time (SMD=-0.43, 95% CI: -1.01 to 0.14, P=0.14) between the 2 groups. Subgroup analysis showed that age might have an effect on spinal deformity. Conclusion LAMP could restore the normal anatomy of spine and reduce the blood loss and postoperative complications, which seems superior to LAMT. Key words: Laminectomy; Laminoplasty; Spinal cord tumor; Meta-analysis

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