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. 2013 Oct;4(2):105–115. doi: 10.1055/s-0033-1357361

Table 5. Evidence summary.

Outcomes Strength of evidence Conclusions/comments
In adult patients with cervical myelopathy, what is the comparative effectiveness of open door vs. French door cervical laminoplasty?
Improvement in myelopathy graphic file with name 10-1055-s-0033-1357361-i1300015sr-6.jpg Overall, data from one CoE II and two CoE III studies suggest that there is no difference between treatment groups in improvement in myelopathy. All three studies found no significant difference in improvement in myelopathy measured by JOA score and JOA recovery rate.
Pain graphic file with name 10-1055-s-0033-1357361-i1300015sr-7.jpg There is insufficient strength of evidence on the comparative effectiveness of open vs. French door laminoplasty regarding pain based on the results of one study. A CoE II RCT reported significant improvement in axial pain following French door laminoplasty compared with open door laminoplasty.
Health care–related quality of life graphic file with name 10-1055-s-0033-1357361-i1300015sr-7.jpg There is insufficient strength of evidence on the comparative effectiveness of open vs. French door laminoplasty regarding health care–related quality of life on the basis of the results of one study. A CoE II RCT reported significantly higher SF-36 scores in four subscales following French door laminoplasty compared with open door laminoplasty.
Complications graphic file with name 10-1055-s-0033-1357361-i1300015sr-6.jpg Overall, data from one CoE II and three CoE III studies suggest that the incidence of complications appears to be higher in the open door laminoplasty group compared with the French door group. One CoE III study reported a higher overall incidence of complications in the open door group (67%) compared with the French door group (16%). Although complete reporting of complications was poor, incidence of pain, neurological complications, infection, bleeding, and restenosis appeared to be higher in the open door treatment group.
In adult patients with cervical myelopathy, are postoperative complications, including pain and infection, different for the use of miniplates vs. the use of no plates following cervical laminoplasty?
Complications graphic file with name 10-1055-s-0033-1357361-i1300015sr-6.jpg Overall, data from one CoE II RCT and one CoE III retrospective cohort study suggest that the incidence of complications appears to be higher in the no plate treatment group compared with the miniplate group. In both studies rates of reoperation, radiculopathy, and infection were higher in the no plate group. In one study patients in the no plate group experienced significantly greater pain as measured by the VAS score compared with the miniplate group.
Are results from cervical laminoplasty (open door compared with French door and the use of miniplates compared with no plates) altered by early active postoperative cervical motion?
Open door vs. French door graphic file with name 10-1055-s-0033-1357361-i1300015sr-7.jpg No evidence available.
Use of miniplates vs. no plates graphic file with name 10-1055-s-0033-1357361-i1300015sr-7.jpg There is insufficient strength of evidence on the effect of early cervical motion on postoperative axial pain. Although neither study conducted a formal analysis of this effect, evidence from one study suggests that earlier postoperative cervical motion might have an effect on pain. One RCT reported that miniplate patients, who wore a collar for 2 weeks, experienced significantly less pain at follow-up than the no plate patients, who wore a collar for 6 weeks.

Abbreviations: CoE, class of evidence; JOA, Japanese Orthopedic Association score; RCT, randomized controlled trial; SF-36, short form 36; VAS, visual analog scale.