Comparative efficacy of contralateral versus ipsilateral open-door laminoplasty for cervical ossification of the posterior longitudinal ligament: a systematic review and meta-analysis

Both contralateral and ipsilateral UODL are effective for managing cervical OPLL, yielding comparable improvements in neurological function, patient-reported outcomes, perioperative parameters, and complication rates. The choice of surgical approach should be individualized, considering specific OPLL morphology (with a potential preference for contralateral UODL in lateral-type OPLL) and the distinct radiographic profiles associated with each technique. Definitive superiority of one technique over the other cannot be established based on current evidence, and further large-scale, high-quality studies are warranted.