Laminectomy versus laminoplasty in the surgical management of long-segment intradural spinal tumors: Any difference in neurological outcomes?

Abstract

e14069 Background: Laminectomy (LAMT) and laminoplasty (LAMP) have been widely applied on patients with spinal cord tumors (SCTs). However, the clinical efficacy of LAMP versus LAMT remains controversial. The purpose of this study is to provide an updated assessment of the safety and efficacy of LAMP compared to LAMT in the treatment of SCTs, incorporating clinical evidence up to 2025. Methods: We searched several databases (PubMed, EMBASE, the Cochrane Library) to identify relevant clinical trials or observational studies. The outcome measures included neurological recovery, resection rates, and perioperative safety metrics. Meta-analysis was performed using a random-effects model. Results: Eighteen studies involving 1,212 patients were included. The results showed statistically significant differences favoring LAMP in terms of blood loss (SMD -2.96; 95% CI: -4.18, -1.75; P < 0.0001), hospital stay (SMD -0.97; 95% CI: -1.54, -0.39; P = 0.001), spinal deformity (OR 0.30; 95% CI: 0.12–0.72; P = 0.007), and cerebrospinal fluid leak (OR 0.19; 95% CI: 0.10–0.35; P < 0.0001). No significant differences were observed in surgery duration (SMD -0.30; 95% CI: -0.83 to 0.23; P = 0.27), effective recovery rate (OR 1.67; 95% CI: 0.40, 6.54; P = 0.51), or total resection rate (OR 1.39; 95% CI: 0.83, 2.33; P = 0.21). Conclusions: LAMP is a safer and more effective surgical method for SCTs, offering advantages in perioperative safety and spinal stability. While no significant difference was observed in surgery duration, neurological recovery, or tumor resection, the lower incidence of spinal deformity and CSF leak suggests that LAMP is a favorable surgical option for long-segment cases.