Open-Door Laminoplasty versus French-Door Laminoplasty in Cervical Compressive Myelopathy: Grading the Evidence through a Meta-Analysis

Purpose: To compare the clinical outcomes of cervical compressive myelopathy with Open-door laminoplasty or French-door laminoplasty. Method: We searched electronic databases including PubMed, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar from 1966 to Feb 2015. No language restriction was applied. We used the Cochrane risk of bias tool to evaluate the trial quality. Each reference list was viewed for any ignore studies. Two authors independently extracted data from all eligible studies, including study design, patients' characteristics, interventions and outcomes. The available data were using random-effects models or fixed-effects with mean differences or stand mean differences for continuous variables. GRADE system was used to assess the level of evidence. Results: The meta-analyses indicated there was no significant difference in operative time and blood loss between Open-door and French-door group (MD -3.87, 95% CI -10.58 to 2.84, P value=0.26, I2=56%; SMD -0.10, 95% CI – 0.63 to 0.42, P value=0.70, I2=72%, repectively). Open-door laminoplasty significantly decreased Japanese Orthopedic Association (JOA) scores when compared with French-door laminoplasty (MD 0.09, 95% CI 0.59 to 1.39, P value<0.00001, I2=0%). Conclusion: Considering the results, we could not confirm which laminoplasty is the better one in patients with cervical compressive myelopathy. More high-quality RCTs were needed to test the result.