小儿脂肪型或紧绷型终丝手术后再拴系的预测因素:对1167例患者的系统回顾和荟萃分析。

IF 2.1 3区 医学 Q3 CLINICAL NEUROLOGY
Journal of neurosurgery. Pediatrics Pub Date : 2024-10-04 Print Date: 2024-12-01 DOI:10.3171/2024.9.PEDS24277
Parker D Smith, Mina Guirguis, Michael Farid, Kwadwo Darko, Shubhang Bhalla, Jason Wang, Umaru Barrie, Brett Whittemore
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引用次数: 0

摘要

研究目的本研究的目的是描述在横切细丝后出现再系带的儿童紧密细丝(TFT)或脂肪细丝(FFT)患者的特征,并确定再系带的风险因素:2023年5月31日,根据《系统综述和荟萃分析首选报告项目》(Preferred Reporting Items for Systematic Reviews and Meta-Analyses,PRISMA)指南,使用PubMed、谷歌学术、SCOPUS和Web of Science数据库进行了系统综述,以确定详细描述TFT或FFT横断后再系带的研究。然后使用纽卡斯尔-渥太华量表对研究进行筛选,以评估偏倚风险:结果:11 篇文章符合纳入标准,共有 1167 名患者在因 TFT 或 FFT 而横断后接受了再系带评估。所有回顾性研究的综合再系带率为3.4%(95% CI为1.6%-5.2%)。随机效应模型用于估算出现症状的发生率,其中最常见的症状是总体队列中的下肢乏力(54.5%,95% CI 32.6%-76.4%),以及系带复位队列中的肠道或膀胱功能障碍(57.9%,95% CI 41.1%-74.8%)。与总体队列(51.1%,95% CI 39.3%-63.0%)相比,经历过系带复位的患者低位圆锥体的估计发生率(71.1%,95% CI 45.1%-97.1%)相似。总体队列中最常见的术后并发症是伤口并发症(2.7%,95% CI 0.8%-4.6%)。术后脑脊液渗漏(OR 13.8,95% CI 3.9-49.4)是预测再系的一个重要因素。初次发病时的感觉改变也是预测再系的一个因素(OR 2.9,95% CI 1.3-6.5)。结论:术前感觉变化和术后感觉变化是预测再系迹的重要因素:结论:术前感觉改变和术后脑脊液渗漏与继发于脂肪性末端丝的系索综合征病例横断丝后的系留率增加有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predictors of postsurgical retethering in pediatric fatty or tight filum terminale: a systematic review and meta-analysis of 1167 patients.

Objective: The objective of this study was to characterize pediatric patients with tight filum terminale (TFT) or fatty filum terminale (FFT) who experienced retethering after transection of the filum, and to determine the risk factors for retethering.

Methods: A systematic review was conducted on May 31, 2023, using PubMed, Google Scholar, SCOPUS, and Web of Science databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify studies detailing retethering following transection for TFT or FFT. Studies were then screened using the Newcastle-Ottawa Scale for risk of bias assessment.

Results: Eleven articles met the inclusion criteria with an overall cohort of 1167 patients evaluated for retethering following transection for TFT or FFT. The combined retethering rate across all retrospective studies was 3.4% (95% CI 1.6%-5.2%). A random-effects model was used to estimate the prevalence of presenting symptoms, with the most common being lower-extremity weakness in the overall cohort (54.5%, 95% CI 32.6%-76.4%) and bowel or bladder dysfunction in the retethered cohort (57.9%, 95% CI 41.1%-74.8%). Patients who experienced retethering had a similar estimated prevalence of low-lying conus (71.1%, 95% CI 45.1%-97.1%) compared with the overall cohort (51.1%, 95% CI 39.3%-63.0%). The most common complication following surgery for the overall cohort was a wound complication (2.7%, 95% CI 0.8%-4.6%). Postoperative CSF leakage (OR 13.8, 95% CI 3.9-49.4) was a strong predictor of retethering. Sensory changes at initial presentation were also found to be a predictor of retethering (OR 2.9, 95% CI 1.3-6.5). Low-lying conus was not predictive of retethering.

Conclusions: Preoperative sensory changes and postsurgical CSF leakage were associated with an increased retethering rate following transection of the filum in cases of tethered cord syndrome secondary to fatty filum terminale.

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来源期刊
Journal of neurosurgery. Pediatrics
Journal of neurosurgery. Pediatrics 医学-临床神经学
CiteScore
3.40
自引率
10.50%
发文量
307
审稿时长
2 months
期刊介绍: Information not localiced
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