Decompression of Lumbar Canal Stenosis with Interlaminar vs Classic Laminectomy: A Systematic Review and Meta-Analysis

Abstract

Purpose: This study aimed to compare the outcomes of interlaminar versus classical laminectomy approaches in the treatment of LCS. Methods: This study conducted a meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline by including randomized controlled trials (RCTs) comparing interlaminar and classical laminectomy in patients with LCS. Relevant studies were identified through systematic searches in Cochrane, PubMed, and Scopus databases using specific keywords related to LCS and surgical outcomes. Data extraction focused on procedure duration, pain scores (VAS), functional disability (Oswestry Disability Index (ODI), and complication rates. Risk of bias was assessed using the Cochrane Risk of Bias tool. Sensitivity analyses were performed by excluding studies at high risk of bias or studies with extreme sample sizes to assess the robustness of the results. All analyses were performed using R, and the statistical significance level was set at p < 0.05, with interpretation taking into account the clinical context and existing heterogeneity. Results: Three RCTs involving 414 patients met the inclusion criteria. The meta-analysis revealed that interlaminar decompression significantly reduced the operation duration (Mean Difference (MD) = -23.82; 95% CI: -26.49 to -21.16; p < 0.001) and postoperative VAS scores (MD = -1.33; 95% CI: -1.46 to -1.21; p < 0.001) compared to classical laminectomy. Improvements in ODI scores were also significantly better in the interlaminar group postoperatively (MD = -9.65; 95% CI: -10.72 to -8.58; p < 0.001). No significant differences were found in complication rates between the two methods.  Conclusion: Interlaminar decompression for LCS provides superior pain relief and functional recovery with shorter operative times compared to classical laminectomy.