Matheus Felipe Henriques Brandão, Ocílio Ribeiro Gonçalves, Gabriel de Almeida Monteiro, Vitor Ribeiro Gonçalves, João Vitor Andrade Fernandes, Thiago Gomes Martins
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引用次数: 0
摘要
低垂头综合征(DHS)是一种罕见的病症,其特征是严重的颈部伸肌无力,导致病理性后凸引起的下巴胸部畸形。本研究旨在评估保守与手术治疗DHS的疗效。对PubMed、Embase和ScienceDirect进行了系统搜索,以获取DHS治疗的研究。结果包括全部/部分改善、成功率和失败率。统计分析使用R软件和“meta”包进行。我们纳入了1252篇文章,包括19项研究和472名患者。其中,134例(28.4%)接受手术治疗,338例(71.6%)接受保守治疗。保守治疗后部分改善59% (95% CI 32.76-83.03%;I²= 78%),总改善率为4.45% (95% CI 0.01-13.21%;I²= 84%)。成功率为6.73% (95% CI 0.74-16.16%;I²= 82%),失败率为100% (95% CI 99.28-100%;I²= 78%)。对于手术治疗,总改善为100% (95% CI 99.57-100%;I²= 18%),成功率也为100% (95% CI 98.37-100%;I²= 0%),异质性较低。只有2例手术失败(95% CI 0.00-1.63%;I²= 0%)。保守治疗在功能恢复和水平凝视方面无效。手术治疗是治疗DHS的首选选择,应被视为一种疾病改善疗法。
Management of dropped head syndrome: a systematic review and single-arm meta-analysis.
Dropped Head Syndrome (DHS) is a rare condition marked by severe neck extensor muscle weakness, leading to a chin-on-chest deformity caused by pathological kyphosis. This study aims to evaluate the efficacy of conservative versus surgical treatments for DHS. A systematic search of PubMed, Embase, and ScienceDirect was conducted for studies on DHS treatments. Outcomes included total/partial improvement, success, and failure rates. Statistical analyses were performed using R software and the "meta" package. We identified 1,252 articles, with 19 studies and 472 patients included. Of these, 134 (28.4%) underwent surgery and 338 (71.6%) received conservative treatment. Partial improvement after conservative treatment was 59% (95% CI 32.76-83.03%; I² = 78%), with total improvement at 4.45% (95% CI 0.01-13.21%; I² = 84%). Success rates were 6.73% (95% CI 0.74-16.16%; I² = 82%), and failure was 100% (95% CI 99.28-100%; I² = 78%). For surgical treatment, total improvement was 100% (95% CI 99.57-100%; I² = 18%), and success was also 100% (95% CI 98.37-100%; I² = 0%), with low heterogeneity. Only two surgical patients failed (95% CI 0.00-1.63%; I² = 0%). Conservative treatment was ineffective in achieving functional recovery and horizontal gaze. Surgical treatment is the preferred option for treating DHS and should be considered a disease-modifying therapy.
期刊介绍:
The goal of Neurosurgical Review is to provide a forum for comprehensive reviews on current issues in neurosurgery. Each issue contains up to three reviews, reflecting all important aspects of one topic (a disease or a surgical approach). Comments by a panel of experts within the same issue complete the topic. By providing comprehensive coverage of one topic per issue, Neurosurgical Review combines the topicality of professional journals with the indepth treatment of a monograph. Original papers of high quality are also welcome.