Alexander O Aguirre, Mohamed A R Soliman, Isabelle G Stockman, Gaitree R Boojraj, Esteban Quiceno, Asham Khan, Kyungduk Rho, John Pollina, Jeffrey P Mullin
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引用次数: 0
Abstract
Purpose: Occipitocervical (OC) fusions are uncommon and challenging surgeries as patients have a wide range of pathologies that could necessitate this procedure. Due to this rarity, limited outcomes data are available for OC fusions. To the authors' knowledge, this is the first meta-analysis on the topic of OC fusions with a specific focus on the current preference of treatment with rigid constructs.
Methods: A literature search of the Embase and PubMed databases was completed from each database's earliest records to April 23, 2024. Studies were included if they focused on rigid construct methods for OC fusions in adults. Meta-analysis was completed adhering to the random effects models, where continuous variables were analyzed with pooled-weighted means (95% confidence intervals [CI]) and categorical variables with pooled-weighted prevalence rates (CI).
Results: A total of 42 studies, encompassing 1,274 patients, were included in this study. Included patients had a mean age of 57.18 years (CI, 52.21-62.15; I2 = 94.47%), with women representing 57.2% (CI, 50.14-64.03; I2 = 53%) of the population. Successful bony fusion was found in 96.7% (CI, 92.54-98.59; I2 = 0%) of cases, with reoperation occurring in 4.7% (CI, 2.62-8.36; I2 = 0%) of patients. Surgical site infection was the most common complication at a rate of 6.97% (CI, 5.19-9.29; I2 = 0%), followed by cerebrospinal fluid leak at 2.9% (CI, 1.32-6.36; I2 = 0%), instrumentation failure at 2.6% (CI, 1.16-5.71; I2 = 0%), vertebral artery injury at 1.6% (CI, 0.74-3.61; I2 = 0%), and screw loosening at 1.4% (CI, 0.65-3.16; I2 = 0%).
Conclusion: Rigid OC fusions have an extremely high likelihood of successful bony fusion and lower complication rates than those previously published, demonstrating a promising current state and future for the procedure.
期刊介绍：
"European Spine Journal" is a publication founded in response to the increasing trend toward specialization in spinal surgery and spinal pathology in general. The Journal is devoted to all spine related disciplines, including functional and surgical anatomy of the spine, biomechanics and pathophysiology, diagnostic procedures, and neurology, surgery and outcomes. The aim of "European Spine Journal" is to support the further development of highly innovative spine treatments including but not restricted to surgery and to provide an integrated and balanced view of diagnostic, research and treatment procedures as well as outcomes that will enhance effective collaboration among specialists worldwide. The “European Spine Journal” also participates in education by means of videos, interactive meetings and the endorsement of educative efforts.
Official publication of EUROSPINE, The Spine Society of Europe
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