Efectividad de la laminectomía versus laminoplastía en la resolución de la estenosis lumbar: revisión sistemática

Abstract

Introduction: Lumbar spinal stenosis is a frequent cause of pain and disability in older adults. Its surgical treatment mainly includes laminectomy and laminoplasty, techniques with significant differences in terms of effectiveness, stability, and postoperative complications. Objective: To compare the clinical effectiveness of laminectomy versus laminoplasty in patients with lumbar spinal stenosis, evaluating functional, biomechanical, and safety parameters. Methodology: A systematic review of 30 studies published between 2001 and 2025 was conducted, retrieved from databases such as PubMed, Scopus, Web of Science, and Cochrane. Clinical trials, cohort studies, and comparative studies evaluating outcomes such as ODI, JOA, instability, bleeding, reoperation rate, and functional recovery were included. NIH methodological quality criteria and a narrative analysis using effect measures (RR, OR, MD) were applied. Results: Laminoplasty showed advantages in several clinical aspects: a lower complication rate (>50% lower), less blood loss (<200 mL), reduced risk of postoperative instability (RR: 0.62), and faster functional recovery (<4 weeks). Although both techniques improved long-term function, laminoplasty better preserved biomechanics and reduced the need for instrumentation. Conclusions: Laminoplasty may represent a more favorable alternative in selected cases, but its implementation depends on surgical experience and available resources. Further high-quality research is recommended to establish definitive guidelines. Keywords: Spinal surgery, lumbar spinal stenosis, laminectomy, laminoplasty, functional recovery.