Efficacy and safety of C3 laminectomy combined with open-door laminoplasty versus open-door laminoplasty alone: A systematic review and meta-analysis.

BACKGROUND To evaluate efficacy and safety between C3 laminectomy + open-door laminoplasty and open-door laminoplasty alone. METHODS Electronic databases are systematically searched up to January 2024. The authors applied Review Manager 5.4 to manage the data and perform the review. Authors conducted Cochrane Library, Pubmed, OVID and Web of Science, search for studies comparing C3 laminectomy + open-door laminoplasty and open-door laminoplasty alone. Forest plots are constructed for each analysis group. RESULTS After selection, 9 eligible articles included 10 comparison groups, with a combined 320patients who underwent C3 laminectomy + open-door laminoplasty, 355 who underwent open-door laminoplasty alone. There is no difference in operative time, blood volume, JOA, JOA recovery, VAS, Neck Disability Index(NDI), complications, axial symptoms, T1S, ROM and cSVA. C3 laminectomy + open-door laminoplasty is superior in C2-C7 Cobb angle. CONCLUSION Although C3 laminectomy + open-door laminoplasty has theoretical advantages, meta-analysis results show that the two surgical procedures are similar in terms of clinical symptoms improvement, sagittal balance, and complications. C3 laminectomy combined + open-door laminoplasty is only superior in the preservation of cervical lordosis. Limited number of studies may affect the reliability and generalizability of the results. Future high-quality, multicenter RCTs are needed to verify efficacy and safety.