Comparative Effectiveness and Functional Outcome of Open-Door versus French-Door Laminoplasty for Multilevel Cervical Myelopathy: A Meta-Analysis

I Gusti Lanang Ngurah Agung Artha Wiguna; Rahadyan Magetsari; Zairin Noor; Suyitno Suyitno; Ricvan Dana Nindrea

doi:10.3889/oamjms.2019.739

Comparative Effectiveness and Functional Outcome of Open-Door versus French-Door Laminoplasty for Multilevel Cervical Myelopathy: A Meta-Analysis

Open Access Maced J Med Sci. 2019 Oct 13;7(19):3348-3352. doi: 10.3889/oamjms.2019.739. eCollection 2019 Oct 15.

Authors

I Gusti Lanang Ngurah Agung Artha Wiguna¹, Rahadyan Magetsari², Zairin Noor³, Suyitno Suyitno⁴, Ricvan Dana Nindrea¹

Affiliations

¹ Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta City, Indonesia.
² Orthopaedic and Traumatology Divison, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Dr Sardjito General Hospital Yogyakarta, Indonesia.
³ Orthopaedic and Traumatology Divison, Faculty of Medicine Universitas Lambung Mangkurat, Banjarmasin, Indonesia.
⁴ Departement of Mechanical and Industrial Engineering Faculty of Engineering Universitas Gadjah Mada, Center for Innovation of Medical Equipments and Devices (CIMEDs) Yogyakarta, Indonesia.

Abstract

Background: 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.

Aim: This study aims to determine comparative effectiveness and functional outcome of open-door versus french-door laminoplasty for multilevel cervical myelopathy.

Methods: 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).

Results: 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).

Conclusion: 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.

Keywords: French-door laminoplasty; Meta-analysis; Multilevel cervical myelopathy; Open-door laminoplasty.

Publication types

Review