Comparison of Lumbar Spinous Process-Splitting Laminectomy versus Conventional Laminectomy for Lumbar Spinal Stenosis: A Systematic Review and Meta-Analysis.

Abstract

This meta-analysis compared the clinical efficacy of lumbar spinous process-splitting laminectomy (LSPSL) and conventional laminectomy (CL) for lumbar spinal stenosis (LSS) for treating lumbar stenosis. We conducted a comprehensive literature review on PubMed, Embase, Cochrane library, and CNKI until March 2024 to identify studies that compared LSPSL with CL for the treatment of LSS. This meta-analysis was carried out with the use of RevMan 5.3 software. Eight studies comprising 801 patients (431 for LSPSL, 370 for CL) were included in this meta-analysis. Comparable outcomes in terms of visual analog scale, Japanese Orthopedic Association scores, Japanese Orthopedic Association recovery rate, Oswestry disability index were noted after surgery. No significant differences were observed in operative time, intraoperative blood loss, complication rates, and re-operation rates. However, LSPSL presented a significantly lower muscular dystrophy rate than CL (weighted mean difference: -16.61, 95% confidence interval: [-21.60, -11.64], P < 0.00001, I² = 0%;). Based on this meta-analysis, both LSPSL and CL can provide a comparably clinical outcomes and complication rates for the treatment of LSS. However, LSPSL demonstrated a superior advantage in terms of muscular dystrophy rate.