A systematic review on comparison of symptoms improvement with two surgical methods for intraspinal tumor

Conservative therapy for intraspinal tumor is mentioned very often in the literature. However, there is no clear reference on surgical method choices for intraspinal tumors. Therefore, we conducted a systematic review to investigate the difference of preoperative and postoperative symptoms between the hemilaminectomy (HEM) and laminectomy (LAM) on intraspinal tumor. A computer based online search of the computerized data bases MEDLINE and PUBMED and EMBASE and ISI Web of Science for articles published from 1970 to January 2011 was performed. Studies that compared hemilaminectomy with laminectomy were included. Data were evaluated by RevMan 5.0 for the systematic review. Six eligible trials including 409 intraspinal cases were considered. The systematic review indicates that hemilaminectomy was more efficient in the improvement of early symptoms than laminectomy. The combined odds ratios (OR) were 2.82, with 95% confidence intervals (CIs) (1.75–4.54). The systematic review indicates that hemilaminectomy was more efficient than laminectomy in the improvement of advanced symptoms. The combined OR was 2.42, with 95% CI (1.56–3.74). In the case of appropriate surgical indications, the choice of hemilaminectomy was better for improving symptoms as cerebrospinal fluid leakage, infection, poor circulation and other possible complications for patients with intraspinal tumor.