Department of Spine Surgery, Taicang Affiliated Hospital of Soochow University, The First People's Hospital of Taicang, Taicang, Jiangsu, China.
Department of Spine Surgery, Shanghai Changzheng Hospital, Shanghai, China.
World Neurosurg. 2023 Dec;180:112-122. doi: 10.1016/j.wneu.2023.09.086. Epub 2023 Sep 26.
The study aims to evaluate the impact of procedural variations in single-door laminoplasty on axial symptoms (AS) and neurologic outcomes.
A comprehensive literature search was conducted across PubMed, EMBASE, and the Cochrane Library, adhering to specific inclusion criteria. We extracted data on the prevalence of AS in both the modified and conventional laminoplasty groups from the selected studies. Neurologic outcomes were assessed using the Japanese Orthopedic Association (JOA) recovery rate, which was subsequently converted to Hedge's g for analysis. Forest plots were generated to visualize the effect sizes, and publication bias was assessed using both funnel plots and Egger's test.
Fourteen studies comprising 1201 patients were included in this meta-analysis focused on AS. The aggregated SMD was -0.891 with a 95% CI of -1.146 to -0.631 (P < 0.01), denoting a statistically significant reduction in AS in the modified laminoplasty group compared with the conventional approach. Of the 14 studies, 10, encompassing 898 patients, contributed data for JOA recovery rate analysis. The overall effect size was 0.089, with a 95% CI ranging from -0.090 to 0.267, and a P value of 0.2901, indicating no significant difference in neurologic outcomes between the 2 techniques. No evidence of publication bias was detected.
This meta-analysis demonstrates that modified laminoplasty is associated with a significant reduction in the incidence and severity of axial symptoms, without compromising neurologic functionality.
本研究旨在评估单开门椎管扩大成形术中手术操作差异对轴性症状（AS）和神经功能结局的影响。
通过对 PubMed、EMBASE 和 Cochrane 图书馆进行全面的文献检索，遵循特定的纳入标准。我们从选定的研究中提取改良和传统椎管扩大成形术组中 AS 发生率的数据。使用日本矫形协会（JOA）恢复率评估神经功能结局，随后转换为 Hedge's g 进行分析。生成森林图以可视化效应大小，并使用漏斗图和 Egger 检验评估发表偏倚。
这项荟萃分析纳入了 14 项研究，共 1201 例患者，重点关注 AS。汇总的 SMD 为-0.891，95%CI 为-1.146 至-0.631（P<0.01），表明与传统方法相比，改良椎管扩大成形术组的 AS 显著减少。在这 14 项研究中，有 10 项研究（共 898 例患者）提供了 JOA 恢复率分析的数据。总体效应大小为 0.089，95%CI 范围为-0.090 至 0.267，P 值为 0.2901，表明两种技术在神经功能结局方面无显著差异。未发现发表偏倚的证据。
这项荟萃分析表明，改良椎管扩大成形术与轴性症状发生率和严重程度的显著降低相关，而不影响神经功能。
