Introduction
Materials and methods
Research questions
Selection criteria
Identification of studies
Statistical analysis
Results
Reference | Study design | Year, journal | Patients | Age | Characteristics of patients | Procedure | Follow-up | Surgical complications | Clinical outcome | Radiographic outcome | Fusion rates | Hardware failure |
---|---|---|---|---|---|---|---|---|---|---|---|---|
(no.) | (year) | |||||||||||
[6] | Retrospective | 1988, Spine | LAMP 15 | LAMP 64 | Multi-level cervical spondylosis | Open-door LAMP; | >2 years | LAMP: subluxation 8, closing of the open door 2 | LAMP: 86% patients were excellent or good | ROM was more limited in LAMP | N/A | N/A |
complete LAMT with bilateral partial facetectomy | ||||||||||||
LAMT 12 | LAMT 64.2 | LAMT: kyphosis 3, subluxation 9 | LAMT: 66% patients were excellent or good, P < 0.05 | |||||||||
[7] | Retrospective | 1988, Spine | LAMP 75 | LAMP 55 | Cervical spondylotic myeloradiculopathy, OPLL | Open-door LAMP; | LAMP 10.8 years | N/A | JOA score improvement: LAMP 81.4% | N/A | N/A | N/A |
LAMT without damage to the facets | ||||||||||||
LAMT 14 | LAMT 59.2 | LAMT 4.6 years | LAMT 81.1% | |||||||||
[8] | Retrospective | 1988, J Bone Joint Surg Br | LAMP 18 | N/A | N/A | French window LAMP; | >5 years | LAMP: kyphosis 5, instability 5 | JOA score: | Limitation of extension was more remarkable after LAMP | N/A | N/A |
No significant difference | ||||||||||||
LAMT 10 | LAMT | LAMT: kyphosis 3, instability 3 | ||||||||||
[9] | Retrospective | 2001, Spine | LAMP 13 | LAMP 56 | Multi-level cervical myelopathy | Open-door/T-saw LAMP; | LAMP 26.2 months (12–46 months) | LAMP 0 | Nurick score: a greater percentage of patients in LAMP group reported a subjective improvement | Significantly greater reduction sagittal plane motion in LAMT | LAMT 61.5% (8/13) | LAMT 2 |
LAMT: myelopathy progression 2, subjacent degeneration 1, infection 1, kyphosis 1, graft site pain 2, revision surgery 1 | ||||||||||||
LAMT 13 | LAMT 55 | complete LAMT and fusion | ||||||||||
LAMT 25.5 months (9–62 months) | ||||||||||||
P > 0.05 | P < 0.01 | |||||||||||
[10] | Retrospective | 2003, Spine | LAMP 51 | LAMP 67 | Multi-level cervical spondylosis, OPLL, spinal canal stenosis | Open-door LAMP; skip LAMT | LAMP 43 months (24–66 m) | LAMP: C5 paresis 3 | Average recovery rates: P > 0.05 | Recovery rate of ROM: LAMP 44%, LAMT 98%, P < 0.05 | N/A | N/A |
Axial symptoms: LAMP 66.7% (34/51), LAMT 2% (1/43), P < 0.05 | ||||||||||||
LAMT 43 | LAMT 69 | |||||||||||
LAMT 30 months (24–41 months) | LAMT: laminar fracture 3, CSF leakage 2 | Difficulty in looking around: LAMP 76% (39/51), LAMT 0% (0/43) | ||||||||||
[11] | Retrospective | 2004, Iowa Orthop J | LAMP 20 | LAMP 53.5 | Multi-level cervical spondylotic myelopathy or radiculopathy | Open-door LAMP with rib allograft; | LAMP 65.4 months (36–112 months) | LAMP: C5 paresis 2, closure of the open door 1 | Modified Nurick scale improvement: LAMP: 43.6%, LAMT 17.8%, P < 0.0001 | ROM: LAMP 27° in extension, LAMT 43° in extension, P < 0.001 | N/A | N/A |
LAMT 22 | LAMT 54.3 | LAMT | ||||||||||
LAMT 64.8 months (53–76 months) | LAMT: wound dehiscence 1, subluxation 2, kyphosis 3 | |||||||||||
VAS score improvement: LAMP 57%, LAMT 8%, P < 0.01 | ||||||||||||
[12] | Prospective | 2007, Spine | LAMP 21 | LAMP 62.3 | Cervical myelopathy and spinal cord compression | Double-door LAMP; | 28.1 months (12–48 months) | No complications in the two groups | Recovery rate of JOA score, P > 0.05 | Recovery rate of ROM: LAMP 77.4%, LAMT 88.6%, P > 0.05, C2–C7 lordosis, P > 0.05 | N/A | N/A |
Skip LAMT | ||||||||||||
LAMT 20 | LAMT 66.1 | VAS score: P > 0.05, supplemental analgesic demands: P > 0.05 | ||||||||||
[13] | Retrospective | 2010, Neurol Res | LAMP 72 | LAMP 59.7 | Cervical spondylotic myelopathy or radiculopathy | LAMP; | 4 months | LAMP: infection 1, wound dehiscence1 | LAMP had better result in Rankin score, Glasgow outcome score, and Karnofsky score (P < 0.01) | N/A | N/A | N/A |
Complete LAMT with preserving the facet joints | ||||||||||||
LAMT 49 | LAMT 57.3 | LAMT: infection2, wound dehiscence1 | ||||||||||
Nurick score: P > 0.05 | ||||||||||||
[14] | Prospective | 2010, J Spinal Disord Tech | LAMP 25 | LAMP 62.4 | Cervical spondylotic myelopathy and spinal cord compression | Double-door LAMP; | >2 years | LAMP: infection 1 | SF12 scores for physical and mental health: P > 0.05 | Recovery rate of ROM: LAMP 46%, LAMT 84%, P < 0.05 | N/A | N/A |
Skip LAMT | ||||||||||||
LAMT 25 | LAMT 69.6 | LAMT: infection 1 | SF12 scores for cervical pain: better for LAMT, P < 0.05 | |||||||||
[15] | Retrospective | 2011, Clin Orthop Relat Res | LAMP 39 | LAMP 60 | Multi-level cervical spondylotic myelopathy | LAMP using Mitek suture anchor fixation; | Average of 24 months | LAMP: chronic pain 2, recurrent stenosis 1, persistent radiculopathy 1, revision surgery 2 | Gait or pain postoperatively: P > 0.05 | Sagittal alignment postoperatively: better in LAMP, P < 0.05 | LAMT: 98.8% (81/82) | LAMT 1 |
LAMT 82 | LAMT 64 | Neck pain: | ||||||||||
LAMT and fusion | P > 0.05 | |||||||||||
LAMT: chronic pain 2, dysphagia 1, infection 1, junctional stenosis 1, kyphosis 1, revision surgery 2 | Junctional kyphosis: P > 0.05 | |||||||||||
[16] | Retrospective | 2011, J Neurosurg Spine | LAMP 30 | LAMP 61 | Cervical stenotic myelopathy | Instrumented, open-door LAMP; LAMT and fusion | LAMP 42.3 months (13–69 months) | LAMP: infection 2, sterile seromas 2, C5 paresis 1, urinary retention 1, revision surgery 4 | Nurick score or JOA score: P > 0.05 | Radiographic outcomes were similar between the groups | LAMT 92% (24/26) | LAMP 2 |
LAMT 2 | ||||||||||||
LAMT: 26 | LAMT: 58 | VAS score improvement: LAMP -0.2 (pain scores increased slightly postoperatively) | ||||||||||
LAMT: 41.3 m (12-85m) | ||||||||||||
LAMT: infection 4, sterile seromas 2, C5 paresis 1, revision surgery 7 | LAMT 2.8, P < 0.05 | |||||||||||
[17] | Prospective | 2012, Neurosurgery | LAMP 9 | LAMP 61 | Multi-level cervical spondylotic myelopathy with or without radiculopathy | Open-door expansile LAMP; | >12 months | No complications in the two groups | Nurick grade, SF-36 score, Neck disability index, self-reported outcome measures were improved only in LAMP, P < 0.05 | ROM was decreased only in LAMT, P < 0.05 | N/A | N/A |
LAMT 7 | LAMT 55 | LAMT and fusion | Percent of change in area of spinal canal: LAMP 34%, LAMT 76%, P < 0.01 | |||||||||
[18] | Retrospective | 2012, Neurosurgery | LAMP 154 | LAMP 67 | Cervical radiculopathy or myelopathy | Standard LAMP; LAMT | LAMP 96 months | N/A | LAMP was associated with more neck pain and worse quality of life (4 or more levels involved); there was no difference (3 or fewer levels) | A greater extent of decompression in LAMP, P < 0.05 | N/A | N/A |
LAMT 114 | LAMT 73 | LAMT 58 months | ||||||||||
Sagittal alignment: P > 0.05 | ||||||||||||
VAS score: P > 0.05 | ||||||||||||
EQ-5D questionnaire: improve significantly in LAMT | ||||||||||||
[19] | Retrospective | 2013, Eur Spine J | LAMP 36 | LAMP 57.1 | Multi-level cervical degenerative myelopathy | Open-door LAMP; LAMT and fusion | LAMP 9.2 months (7–11 months) | N/A | Final follow-up JOA score and neurological recovery rate: P > 0.05 | Loss of curvature index: LAMP 2.60 ± 1.01, LAMT 1.22 ± 0.72, P < 0.05 | N/A | N/A |
LAMT 32 | LAMT 55.9 | |||||||||||
Axial symptom incidence: LAMP 66.7 % (24/36), LAMT 37.5 % (12/32), P < 0.05 | ||||||||||||
LAMT 8.9 months (7–12 months) | ||||||||||||
[20] | Retrospective | 2013, Orthopedics | LAMP 75 | LAMP 57.2 | Multi-level cervical stenotic myelopathy | Plate-only open-door LAMP; | >24 months | LAMP: C5 paresis 3, CSF leakage 1, kyphosis 3, restenosis 1, axial pain 9 | JOA score and Nurick score: P > 0.05 | Increase of dural sac area: LAMP 31.9%, LAMT 52.7%, P < 0.001 | LAMP 98.67% (74/75) | N/A |
LAMT 66 | LAMT 57 | LAMT and fusion | NDI scores and VAS scores: better improvement in LAMP, P < 0.05 | |||||||||
Spinal cord shift: LAMP 1.2 mm, LAMT 2.4 mm, P < 0.001 | LAMT 96.97% (64/66) | |||||||||||
LAMT: C5 paresis 11, CSF leakage 3, kyphosis 2, infection 1, axial pain 23 | Better neck function recovery in LAMP | |||||||||||
Curvature index: P > 0.05 | P > 0.05 | |||||||||||
Greater loss of ROM in LAMT |
Operative time and estimated blood loss
Reference | Year | Operative time of LAMP (min) | Operative time of LAMT (min) | Blood loss of LAMP (ml) | Blood loss of LAMT (ml) |
---|---|---|---|---|---|
[7] | 1988 | 151 | 169.2 | 505 | 343.3 |
[10] | 2003 | 114 | 133 | 249 | 18 |
[11] | 2004 | 201 | 165 | 505 | 310 |
[12] | 2007 | 63 | 77 | 44 | 43 |
[14] | 2010 | 108 | 70 | 105 | 50 |
[17] | 2012 | 180 | 210 | 405 | 500 |
[20] | 2013 | 145.1 | 173.8 | 284.5 | 310.9 |
Surgical complications
Complication | References | LAMP (%) | LAMT (%) | P value |
---|---|---|---|---|
Kyphosis | 8/180 (4.44) | 13/205 (6.34) | 0.413 | |
C5 paresis | 9/176 (5.11) | 12/157 (7.64) | 0.343 | |
Infection | 4/254 (1.57) | 10/261 (3.83) | 0.192 | |
Subluxation | 8/35 (22.86) | 11/34 (32.35) | 0.377 | |
Instability | [8] | 5/18 (27.78) | 3/10 (30.05) | 1.000 |
CSF leakage | 1/126 (0.79) | 5/109 (4.59) | 0.154 | |
Wound dehiscence | 1/92 (1.09) | 2/71 (2.82) | 0.820 | |
Urinary retention | [16] | 1/30 (3.33) | 2/26 (7.69) | 0.899 |
Chronic pain | 11/114 (9.65) | 25/148 (16.89) | 0.091 | |
Restenosis | 2/114 (1.75) | 1/82 (1.22) | 1.000 | |
Nonunion | 6/157 (3.82) | 5/187 (2.67) | 0.547 | |
Hardware failure | 2/82 (2.44) | 5/121 (4.13) | 0.797 | |
Revision surgery | 6/82 (7.32) | 10/121 (8.26) | 0.806 |