Efficacy of unilateral hemilaminectomy for intraspinal tumor resection: A systematic review and meta-analysis

Abstract

Background: To evaluate, via a meta-analysis, the clinical effect of unilateral hemilaminectomy for intraspinal tumor removal. Methods: PubMed, Springer, Wanfang Data, CBM, CNKI, and other databases were searched for relevant randomized controlled trials (RCT), in Chinese and other languages, that involved comparisons of unilateral hemilaminectomy with other techniques for intraspinal tumor removal. Results: Thirteen RCTs were finally included, with a total of 1,424 patients. Unilateral hemilaminectomy for intraspinal tumor removal was found to reduce the amount of intraoperative hemorrhage (Z =45.67, P<0.00001), operative time (Z =55.35, P<0.00001), length of hospital stay (Z =111.67, P<0.00001), and inbed time (Z =142.08, P<0.00001) of patients. Compared with the traditional operative methods, unilateral hemilaminectomy for intraspinal tumor removal can improve the cure rate of patients [odds ratio (OR) =3.84; 95% confidence interval (CI), 2.1–7.01; Z =4.38; P<0.001) and reduce the incidence of spinal deformities (OR =0.11; 95% CI, 0.04–0.34; Z =3.83; P=0.001). It does not increase the risks of postoperative cerebrospinal fluid leak (OR =0.63; 95% CI, 0.21–1.88; Z =0.82; P=0.41), postoperative infection (OR =0.74; 95% CI, 0.31–1.77; Z =0.67; P=0.50), pain (OR =0.29; 95% CI, 0.07–1.18; Z =1.73; P=0.08), myasthenia (OR =−0.04; 95% CI, −0.07 to 0.01; Z =2.29; P=0.02), and other complications. Conclusions: Unilateral hemilaminectomy for the microsurgical removal of intraspinal tumors has the advantages of minimal operative trauma, fast recovery, and better postoperative stability of the vertebral column.