Patients with Seizure Disorders Undergoing Surgery for Recurrent Anterior Shoulder Instability Demonstrate Variable Rates of Recurrence with Seizures as the Most Common Cause of Failure: A Systematic Review.
Scott Fong, Fabrizio Darby, Seema Patel, James D Fox, Michael S Lee, Jay Moran, Stephen M Gillinov, Mackenzie Norman, Justin Zhu, Ronak J Mahatme, John M Apostolakos, Andrew E Jimenez
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引用次数: 0
Abstract
Purpose: To evaluate postoperative outcomes of patients with seizure disorder undergoing stabilization surgery for the treatment of recurrent anterior shoulder instability.
Methods: Pubmed, Cochrane Center for Register of Controlled Trials (CENTRAL) and Scopus were searched in January 2024 for articles using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) criteria. Articles were included if they evaluated postoperative functional, clinical, or recurrence/reoperation outcomes following surgical stabilization in patients with a history of seizures and recurrent anterior shoulder instability. For postoperative outcomes reported in three or more studies with mean and standard deviation, forest plots were generated, and I2 was calculated.
Results: A total of eight studies were included: seven studies focused on the Latarjet or other bone block augmentation procedures and one study focused on a soft tissue-only stabilization procedure. There were a total of 157 Latarjet or bone block augmentation surgeries (143 patients: 124 M (86.7%), 19 F (13.3%)) and 29 soft tissue only stabilization surgeries (27 patients: 23 M (85.2%), 4F (14.8%)). Recurrent dislocation or subluxation rates ranged from 0% to 43%. Of the five studies that reported the cause of postoperative dislocation or instability, four identified seizures as the cause of all cases. In studies comparing Latarjet outcomes between patients with versus without seizure disorders, instability recurrence ranged from 1.8% to 9.5% in the non-seizure group and from 9% to 40% in the seizure group.
Conclusion: The recurrence of anterior shoulder instability after surgical stabilization in patients with seizure disorders was variable across studies ranging from 0% to 43%. Seizure was the most common reported cause for recurrent instability after surgery.
Level of evidence: Level IV, systematic review of Level III and IV studies.
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