Jagtiani Pemla, Karabacak Mert, Jenkins Arthur L, Margetis Konstantinos
School of Medicine, SUNY Downstate Health Sciences University, New York, NY, 11203, USA.
Department of Neurosurgery, Mount Sinai Health System, New York, NY, 10029, USA.
Neurosurg Rev. 2023 Dec 8;47(1):5. doi: 10.1007/s10143-023-02239-2.
While multiple studies exist comparing cervical laminoplasty (CLP) and posterior cervical laminectomy with fusion (PCF), no clear consensus exists on which intervention is better. An umbrella review helps provide an overall assessment by analyzing a given condition's multiple interventions and outcomes. It integrates all available information on a topic and allows a consensus to be reached on the intervention of choice. A literature search was conducted using specific search criteria in PubMed, Scopus, and Web of Science databases. Titles and abstracts were screened based on inclusion criteria. A full-text review of articles that passed the initial inclusion criteria was performed. Nine meta-analyses were deemed eligible for the umbrella review. Data was extracted on reported variables from these meta-analyses. Subsequent quality assessment using AMSTAR2 and data analysis using the R package metaumbrella were used to determine the significance of postoperative outcomes. When the meta-analyses were pooled, statistically significant differences between CLP and PCF were found for postoperative overall complications rate and postoperative JOA score. PCF was associated with a lower overall complication rate and a higher postoperative JOA score, both supported by a weak level of evidence (class IV). Data regarding all other outcomes were non-significant. Our umbrella review investigates CLP and PCF by providing a comprehensive overview of existing evidence and evaluating inconsistencies within the literature. This umbrella review revealed that PCF had better outcomes for overall complications rate and postoperative JOA than CLP, but they were classified as being of weak significance.
虽然存在多项比较颈椎板成形术（CLP）和颈椎后路椎板切除术融合术（PCF）的研究，但对于哪种干预措施更好尚无明确共识。一项系统综述有助于通过分析给定病症的多种干预措施和结果来提供全面评估。它整合了关于某个主题的所有可用信息，并就首选干预措施达成共识。使用PubMed、Scopus和Web of Science数据库中的特定搜索标准进行文献检索。根据纳入标准筛选标题和摘要。对通过初步纳入标准的文章进行全文审查。九项荟萃分析被认为符合系统综述的条件。从这些荟萃分析中提取报告变量的数据。随后使用AMSTAR2进行质量评估，并使用R包metaumbrella进行数据分析，以确定术后结果的显著性。当汇总荟萃分析时，发现CLP和PCF在术后总体并发症发生率和术后JOA评分方面存在统计学显著差异。PCF与较低的总体并发症发生率和较高的术后JOA评分相关，两者均得到弱证据水平（IV级）的支持。关于所有其他结果的数据无显著性。我们的系统综述通过全面概述现有证据并评估文献中的不一致性来研究CLP和PCF。这项系统综述表明，PCF在总体并发症发生率和术后JOA方面的结果优于CLP，但它们被归类为显著性较弱。
