Complications Following Cervical Laminoplasty With Reconstruction: A Systematic Review and Meta-Analysis

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Surgery

Background:

• Cervical laminoplasty with reconstruction is a common posterior decompression technique for degenerative cervical myelopathy (DCM) and ossification of the posterior longitudinal ligament (OPLL).
• Postoperative complications are a concern, yet quantitative data on their incidence is limited.
• This study addresses the need for a focused synthesis of complication rates.

Purpose of the Study:

• To synthesize pooled complication rates following cervical laminoplasty with reconstruction.
• To evaluate differences in complication rates between DCM and OPLL surgical indications.

Main Methods:

• Systematic review and random-effects meta-analysis of 68 studies (6,732 patients) from PubMed, Embase, and Scopus.
• Pooled incidence of specific complications calculated using Freeman-Tukey double arcsine transformation.
• Subgroup analyses compared DCM and OPLL cohorts; meta-regression examined follow-up duration's impact.

Main Results:

• Pooled complication incidences: C5 palsy 4.07%, axial neck pain 13.74%, reoperation 2.72%, dural/CSF 1.48%, wound infection 1.89%, hematoma 0.25%, airway/dysphagia 0.68%, progressive kyphosis 0.80%.
• C5 palsy was significantly higher in OPLL (5.86%) versus DCM (3.34%) cohorts (P=0.021).
• No significant association found between follow-up duration and complication rates; high heterogeneity noted.

Conclusions:

• This meta-analysis provides crucial pooled incidence estimates for complications after cervical laminoplasty with reconstruction.
• C5 palsy is more frequent in OPLL patients, while axial neck pain is the most common but inconsistently defined complication.
• Standardized definitions and reporting are essential for future research and clinical comparisons.