颈椎手术后C5麻痹的发生率和康复率:一项系统回顾和荟萃分析。

IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY
Isabelle G Stockman, Mohamed A R Soliman, Esteban Quiceno, Alexander O Aguirre, Mirza Baig, Ayub Ansari, Yazan Tanbour, Amna Aslam, Hannon W Levy, Moleca M Ghannam, Cathleen C Kuo, Justin Im, Evan Burns, Evan M Sood, Umar Masood, Hendrick Francois, Lauren C Levy, Rehman Baig, Asham Khan, John Pollina, Jeffrey P Mullin
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引用次数: 0

摘要

背景和目的:C5神经麻痹是颈椎手术的一种衰弱性并发症,可在某些入路后发生。据我们所知,之前没有系统综述比较过不同颈椎入路后C5神经麻痹的发生率,以确定该并发症变为永久性的发生率。我们的目的是比较不同颈椎手术入路后C5麻痹的发生率和存在C5麻痹时的恢复率。方法:对PubMed和Embase数据库从建立到2023年7月1日的文献进行检索,以确定专注于颈椎手术的研究。如果研究没有提供C5麻痹发生率或确定使用哪种手术入路,则排除研究。计算每种方法C5麻痹的合并加权患病率,包括永久性C5麻痹的发生率。结果:155项研究符合纳入标准。在这些研究中,22例(14.2%)报道椎板切除术,77例(49.7%)报道椎板成形术,38例(24.5%)报道颈椎后路减压融合,39例(25.2%)报道颈前盘切除术融合,4例(2.6%)报道椎体切除术。行椎板切除术的患者C5麻痹发生率最高,总发生率为8%,其中1.44%为永久性麻痹。其次是颈椎后路减压融合,发生率为7.03%,固定率为1.02%。椎板成形术患者C5麻痹发生率为5.11%;其中,0.28%的病例是永久性的。椎体切除术患者发病率为4.16%;颈前路椎间盘切除术合并融合术发生率最低,为2.61%,其中永久性发生率为1.06%。结论:C5神经麻痹是颈椎手术后的一个已知并发症,在后路手术中发病率增加,尽管这些并发症成为永久性的比例很小。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Incidence of C5 Palsy and Recovery Rate After Cervical Spine Surgery: A Systematic Review and Meta-Analysis.

Background and objectives: C5 nerve palsy is a debilitating complication of cervical spine surgery that can occur after certain approaches. To our knowledge, no previous systematic reviews have compared the rates of C5 nerve palsy after different cervical approaches, identifying the rate at which this complication becomes permanent. We aimed to compare the rates of C5 palsy after different cervical spine surgery approaches and the rates of recovery when C5 palsy was present.

Methods: A literature search of the PubMed and Embase databases from their inception to July 1, 2023, was completed to identify studies that focused on cervical spine surgery. Studies were excluded if they did not provide the rate of C5 palsy occurrence or define which surgical approaches were used. A pooled, weighted prevalence rate of C5 palsy was calculated for each approach, including the rate of permanent C5 palsy.

Results: A total of 155 studies met the inclusion criteria. Of these studies, 22 (14.2%) reported on laminectomies, 77 (49.7%) on laminoplasties, 38 (24.5%) on posterior cervical decompression and fusion, 39 (25.2%) on anterior cervical diskectomy and fusion, and 4 (2.6%) on corpectomies. Patients who had laminectomies had the highest incidence of C5 palsy at a pooled rate of 8%, of which 1.44% of cases were permanent. This was followed by posterior cervical decompression and fusion with a rate of 7.03% and a permanence rate of 1.02%. Patients receiving laminoplasties had a C5 palsy incidence of 5.11%; of these, 0.28% of cases were permanent. Patients who had corpectomies had an incidence of 4.16%; those who had anterior cervical diskectomy and fusions had the lowest incidence of 2.61%, of which 1.06% of cases were permanent.

Conclusion: C5 nerve palsy is a known complication after cervical spine surgeries, with increased rates in posterior approaches, although the rate of these complications becoming permanent is minimal.

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来源期刊
Neurosurgery
Neurosurgery 医学-临床神经学
CiteScore
8.20
自引率
6.20%
发文量
898
审稿时长
2-4 weeks
期刊介绍: Neurosurgery, the official journal of the Congress of Neurological Surgeons, publishes research on clinical and experimental neurosurgery covering the very latest developments in science, technology, and medicine. For professionals aware of the rapid pace of developments in the field, this journal is nothing short of indispensable as the most complete window on the contemporary field of neurosurgery. Neurosurgery is the fastest-growing journal in the field, with a worldwide reputation for reliable coverage delivered with a fresh and dynamic outlook.
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