Wiguna I Gusti Lanang Ngurah Agung Artha, Magetsari Rahadyan, Noor Zairin, Suyitno Suyitno, Nindrea Ricvan Dana
Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta City, Indonesia.
Orthopaedic and Traumatology Divison, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr Sardjito General Hospital Yogyakarta, Indonesia.
Open Access Maced J Med Sci. 2019 Oct 13;7(19):3348-3352. doi: 10.3889/oamjms.2019.739. eCollection 2019 Oct 15.
At present, few reports are comparing these 2 major cervical posterior laminoplasty methods with Open-door and French-door Laminoplasty in terms of neurological recovery, cervical alignment, and surgical complications. Moreover, most of the research has not been well designed.
This study aims to determine comparative effectiveness and functional outcome of open-door versus french-door laminoplasty for multilevel cervical myelopathy.
The Meta-analysis is used in this study. The study sample is a published research articles on comparative effectiveness and functional outcome of open-door versus french-door laminoplasty for multilevel cervical myelopathy on the internet through databases on PubMed and ProQuest and published between 1997 until December 2018. Weighted mean difference and pooled weighted mean difference are calculated by using the fixed-effect model or random-effect model. Data is processed by using Review Manager 5.3 (RevMan 5.3).
This study reviews 58 articles. There are 6 studies conducted a systematic review and continued with Meta-analysis of relevant data. The results showed significant higher postoperative Japanese Orthopaedic Association (JOA) score in open-door laminoplasty (ODL) than French-door laminoplasty (FDL) (weighted mean difference [WMD] = 0.71; 95% confidence interval [CI]: 0.35 to 1.07; p < 0.05). The outcome of procedures treatment of multilevel cervical myelopathy revealed the operative time, cervical range of motion, axial canal diameter postoperative, axial pain reduction and complications events in ODL and FDL there was no significant difference. But for a cervical lordotic angle in ODL and FDL, there was a significant difference; the ODL group were significantly lesser than the FDL group. The recovery rate in ODL and FDL, there was a significant difference; the ODL was shown to be significantly higher than FDL (p < 0.05).
This analysis suggests that neither cervical laminoplasty approach is superior, based on the postoperative radiological data and complication rate. But the open-door laminoplasty resulted in a higher functional outcome and recovery rate as compared to the French-door laminoplasty.
目前，很少有报告在神经功能恢复、颈椎对线和手术并发症方面比较这两种主要的颈椎后路椎板成形术方法，即开门式和法式开门式椎板成形术。此外，大多数研究设计并不完善。
本研究旨在确定多节段颈椎脊髓病的开门式与法式开门式椎板成形术的相对疗效和功能结果。
本研究采用荟萃分析。研究样本是通过PubMed和ProQuest数据库在互联网上发表的关于多节段颈椎脊髓病的开门式与法式开门式椎板成形术的相对疗效和功能结果的研究文章，发表时间为1997年至2018年12月。使用固定效应模型或随机效应模型计算加权平均差和合并加权平均差。数据使用Review Manager 5.3（RevMan 5.3）进行处理。
本研究回顾了58篇文章。有6项研究进行了系统评价并继续对相关数据进行荟萃分析。结果显示，开门式椎板成形术（ODL）术后日本骨科协会（JOA）评分显著高于法式开门式椎板成形术（FDL）（加权平均差[WMD]=0.71；9５%置信区间[CI]：0.35至1.07；p<0.05）。多节段颈椎脊髓病手术治疗的结果显示，ODL和FDL在手术时间、颈椎活动范围、术后椎管直径、轴性疼痛减轻和并发症发生率方面无显著差异。但ODL和FDL在颈椎前凸角方面存在显著差异；ODL组明显小于FDL组。ODL和FDL的恢复率存在显著差异；ODL显示明显高于FDL（p<0.05）。
该分析表明，基于术后放射学数据和并发症发生率，两种颈椎椎板成形术方法均无优势。但与法式开门式椎板成形术相比，开门式椎板成形术具有更高的功能结果和恢复率。
