Comparison of single versus double door posterior cervical laminoplasty for patients with cervical spondylotic myelopathy: A systematic review and meta-analysis

OBJECTIVE: We undertook a meta-analysis to compare the efficacy and safety of single versus double door posterior cervical laminoplasty for cervical spondylotic myelopathy. METHODS: PubMed, Embase, and Cochrane Central Register of controlled trials were searched for randomized controlled trials investigating single and double door posterior cervical laminoplasty for cervical spondylotic myelopathy. The Mantel–Haenszel method with the fixed-effects or random-effects model was used to calculate relative risks and 95% confidence intervals (CIs). RESULTS: Seven studies with 224 patients met the eligibility criteria and were included. There was a significant difference in Japanese Orthopedic Association score (MD = 0.79, 95%CI [0.09, 1.49], P = .03; P for heterogeneity = .09, I(2) = 45%), and adverse events (OR = 0.32, 95%CI [0.11, 0.95], P = .04; P for heterogeneity = 1.00, I(2) = 0%) between the double door posterior cervical laminoplasty group and the single door posterior cervical laminoplasty group. There was no significance in operative time (MD = 0.56, 95%CI [–11.86, 12.98], P = .93; P for heterogeneity = 0.001, I(2) = 73%) and length of hospital stay (OR = –0.75, 95%CI [–1.78, 0.27], P = .15; P for heterogeneity = 1.00, I(2) = 0%) between the 2 groups. CONCLUSION: Double door posterior cervical laminoplasty is more effective and safer than single door laminoplasty in the treatment of cervical spondylotic myelopathy.