Table 3.
Summary of clinical studies evaluating laminectomy versus laminoplasty
| Study | Technique | Design | JOA/NDI/Nurick Scale scores | ROM | VAS | |||
|---|---|---|---|---|---|---|---|---|
| Ross and Ross, [55] 2018 | Minimally invasive laminectomy | Case series, retrospective | JOA | N/A | N/A | |||
| N = 30 | Preop: 12.1 | |||||||
| Postop (3 months): 14 | ||||||||
| Statistically significant difference | ||||||||
| Otani et al., [56] 2009 | Partial segmental laminectomy vs. ELAP | Retrospective cohort study | JOA | ROM: | N/A | |||
| • | Laminectomy | • | Laminectomy | |||||
| Preop: 11.1±2.6 | Preop: 39.9±14.3 | |||||||
| 5 year: 14.2±1.7 | 5-year degrees: 24.8±9.3 | |||||||
| • | Laminoplasty | • | Laminoplasty | |||||
| Preop: 9.5±3.4 | Preop: 39.8±18.6 | |||||||
| 5 year: 12.8±3.1 | 5 years: 17.1±16.4 | |||||||
| • | Difference not significant | |||||||
| Reduction in ROM >in ELAP group statistically significant, p<0.005 | ||||||||
| Shiraishi, [57] 2002 | Skip laminectomy, 2-year follow-up | Retrospective cohort | JOA | Preop: 38.3 | N/A | |||
| N = 24 | Preop: 9.4 | Postop: 36.9 | ||||||
| Postop: 14.0 | ||||||||
| Yukawa et al., [58] 2007 | Skip laminectomy vs. laminoplasty | Prospective, randomized controlled trial | JOA | • | Skip laminectomy | N/A | ||
| • | Skip laminectomy | Preop: 43.4±10.4 | ||||||
| Preop: 10.1 | Postop: 37.2±9.5 | |||||||
| Postop: 13.6 | • | Laminoplasty | ||||||
| • | Laminoplasty | Preop: 49.0±10.7 | ||||||
| Preop: 11.1 | Postop: 35.8±10.2 | |||||||
| Postop: 14.4 | • | Difference not significant | ||||||
| • | Difference not significant | |||||||
| Stamates, [59] 2017 | Cervical laminoplasty, outcomes at 2 years | Prospective cohort | Nurick | N/A | Preop: 2.84±1.2 | |||
| Preop: 3.16±0.9 | Postop: 1.69±0.9 | |||||||
| Postop: 1.94±0.8 | Significant difference, p<0.05 | |||||||
| Significant difference, p<0.05 | ||||||||
| Hardman, [60] 2009 | Laminoplasty vs. laminectomy | Retrospective cohort | Nurick | N/A | N/A | |||
| Mean change in Nurick score not significant, p < 0.62 | ||||||||
| Laminoplasty | ||||||||
| Rankin scale significantly greater improvement in laminoplasty group, p < 0.0001 | ||||||||
| Fehlings et al., [61] 2017 | Laminectomy and fusion vs. laminoplasty | International prospective multicenter | JOA | N/A | N/A | |||
| • | Laminectomy and fusion | |||||||
| Preop: 12.3 | ||||||||
| Postop: 14.69 | ||||||||
| • | Laminoplasty | |||||||
| Preop: 11.52 | ||||||||
| Postop: 15.01 | ||||||||
| • | Significant difference | |||||||
| Chang et al., [62] 2017 | Selective laminectomy for CSM, comparative analysis with laminoplasty | Retrospective cohort | NDI | • | Laminectomy | • | Laminectomy | |
| • | Laminectomy | Preop: 20±10.76 | Preop: 2.8±2.5 | |||||
| Preop: 18.3±6.6 | Postop: 9.91±8.54 | Postop: 1.7±2.0 | ||||||
| Postop: 14.8±7.4 | • | Laminoplasty | • | Laminoplasty | ||||
| • | Laminoplasty | Preop: 17.04±9.19 | Preop: 3.4±2.3 | |||||
| Preop: 17.9±10.7 | Postop: 15.05±9.6 | Postop: 2.7±1.9 | ||||||
| Postop: 13.8±4.1 | • | Significant difference | • | Significant difference | ||||
| • | Significant difference | |||||||
| Lau et al., [63] 2017 | Laminoplasty vs. laminectomy with posterior spinal fusion for multilevel CSM | Retrospective cohort | Nurick | N/A | • | Laminectomy | ||
| • | Laminectomy | Preop: 6.9±2.4 | ||||||
| Preop: 2.1±1.3 | Postop: 1.1±2.5 | |||||||
| Postop: 0.9±1.3 | • | Laminoplasty | ||||||
| • | Laminoplasty | Preop: 5.6±2.6 | ||||||
| Preop: 2.1±1.4 | Postop: 1.0±2.2 | |||||||
| Postop: 1.4±1.5 | • | Significant difference | ||||||
| • | Significant difference | |||||||
| Heller et al., [64] 2001 | Laminoplasty vs. laminectomy and fusion for multilevel cervical myelopathy | Retrospective cohort | Nurick | N/A | N/A | |||
| • | Laminectomy | |||||||
| Preop: 2.2 | ||||||||
| Postop: 1.5 | ||||||||
| • | Laminoplasty | |||||||
| Preop: 2.3 | ||||||||
| Postop: 1.1 | ||||||||
| • | Difference not significant | |||||||
| Manzano et al., [65] 2012 | A prospective, randomized trial comparing expansile cervical laminoplasty and cervical laminectomy and fusion for multilevel cervical myelopathy | Prospective randomized trial | • | Laminectomy and fusion | Significant decrease in ROM in laminectomy/fusion group | |||
| Preop: 12.57±1.09 | ||||||||
| Postop: 13.57±1.02 | ||||||||
| • | Laminoplasty | 75% reduction in CLF vs. 20% reduction in laminoplasty group | ||||||
| Preop: 12.37±1.2 | ||||||||
| Postop: 14.25±0.96 | ||||||||
| • | Difference not significant | |||||||
| Significant difference in Nurick grade for ECL group (preop vs. postop) | ||||||||
| Du et al., [66] 2013 | Long-term impacts of different posterior operations on curvature, neurological recovery, and axial symptoms for multilevel cervical degenerative myelopathy | Retrospective cohort | JOA | ROM | N/A | |||
| • | Laminectomy | |||||||
| Preop: 8.10±1.18 | ||||||||
| Postop: 13.07±1.23 | ||||||||
| • | Laminoplasty | |||||||
| Preop: 8.08±1.13 | ||||||||
| Postop: 13.97±1.28 | ||||||||
| • | Laminectomy+lateral mass | |||||||
| Preop: 8.16±1.11 | ||||||||
| Postop 14.31±1.33 | ||||||||
| Statistically significant differences between preop and final follow-up JOA scores in each group (p<0.001) and in final follow-up JOA scores among the 3 groups (F=7.81, p<0.001). | ||||||||
| No significant difference in preop | ||||||||
| JOA scores among the 3 groups and in final follow-up JOA scores between the LP and LCS groups. | ||||||||
JOA, Japanese Orthopaedic Association; NDI, neck disability index; ROM, range of motion; VAS, visual analogue scale; Preop, preoperative; Postop, postoperative; ELAP, expansive open-door laminoplasty; N/A, not available; ECL, expansile cervical laminoplasty; CLF, cervical laminectomy and fusion.