Cong Lin, Zhu Yue, Yan Qi, Tu Guanjun
Department of Orthopedic surgery, The First Hospital of China Medical University, Shenyang City, China.
Department of Orthopedic surgery, The First Hospital of China Medical University, Shenyang City, China.
World Neurosurg. 2017 Sep;105:95-101. doi: 10.1016/j.wneu.2017.05.103. Epub 2017 May 27.
Symptomatic lumbar spinal stenosis (LSS), which leads to severe socioeconomic consequences and places a heavy burden on global healthcare system, is a relatively frequent spine disorder. Redundant nerve roots (RNRs) are a relatively common finding in which slender, serpiginous, or tortuous nerve roots are found in the subarachnoid space of the lumbar spine. Previous studies that evaluated the prognostic assessment of RNRs in patients with symptomatic LSS are composed of doubtful results. Therefore, the clinical significance of RNRs in symptomatic LSS is still uncertain. The aim of this meta-analysis is a systematic assessment of the clinical significance of RNR syndrome in symptomatic LSS.
This study used a highly sensitive search strategy to identify all published studies in multiple databases up to January 1, 2017. All identified trials were systematically evaluated using specific inclusion and exclusion criteria. Cochrane methodology was also applied to the results of this study.
This study identified 4 relevant studies involving 297 patients. Compared with a non-RNR group, the RNR group results included worse clinical outcomes that were assessed using the Japanese Orthopedic Association scores after surgery (weighted mean difference [WMD], -0.78; 95% confidence interval [CI], -1.26 to -0.29; P = 0.002; I = 0%), for recovery rate (WMD, -9.87; 95% CI, -15.07 to -4.67; P = 0.0002; I = 0%), and for older age (WMD, 2.51; 95% CI, 0.45-4.57; P = 0.02; I = 43%).
RNR is an entity in association with symptomatic LSS, which may be viewed as a potentially powerful prognostic indicator of worse postoperative functional recovery for symptomatic LSS.
症状性腰椎管狭窄症（LSS）是一种相对常见的脊柱疾病，会导致严重的社会经济后果，并给全球医疗系统带来沉重负担。冗余神经根（RNRs）是一种相对常见的情况，即在腰椎蛛网膜下腔发现细长、蜿蜒或迂曲的神经根。以往评估症状性LSS患者RNRs预后的研究结果存在疑问。因此，RNRs在症状性LSS中的临床意义仍不确定。本荟萃分析的目的是系统评估RNR综合征在症状性LSS中的临床意义。
本研究采用高灵敏度搜索策略，检索截至2017年1月1日多个数据库中所有已发表的研究。所有纳入的试验均使用特定的纳入和排除标准进行系统评估。本研究结果也采用了Cochrane方法。
本研究确定了4项相关研究，涉及297例患者。与非RNR组相比，RNR组的结果包括术后使用日本骨科协会评分评估的临床结局更差（加权平均差[WMD]，-0.78；95%置信区间[CI]，-1.26至-0.29；P = 0.002；I = 0%），恢复率更差（WMD，-9.87；95%CI，-15.07至-4.67；P = 0.0002；I = 0%），以及年龄更大（WMD，2.51；95%CI，0.45 - 4.57；P = 0.02；I = 43%）。
RNR是与症状性LSS相关的一种情况，可被视为症状性LSS术后功能恢复较差的一个潜在有力预后指标。
