Farahbakhsh Farzin, Khosravi Sepehr, Baigi Vali, Pourghahramani Koltapeh Masoud, Khayyamfar Amirmahdi, Eskandari Zahra, Ghodsi Zahra, Harrop James, Rahimi-Movaghar Vafa
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Global Spine J. 2024 Apr;14(3):1052-1060. doi: 10.1177/21925682231202776. Epub 2023 Sep 20.
Systematic review and meta-analysis.
The aim of this study was to determine the prevalence of asymptomatic cervical spinal cord compression (CSCC) in individuals with lumbar spinal stenosis (LSS).
A systematic electronic search was conducted in Medline, EMBASE, Scopus, and Web of Science without language restriction, with no starting date limit to June 8, 2023, to define the prevalence of asymptomatic CSCC in symptomatic LSS patients. Asymptomatic CSCC was defined based on radiographic studies. All types of studies were included in the review. Meta-analysis was performed on the reported prevalence of asymptomatic CSCC in LSS.
The database search yielded 10,272 articles. After a full-text review, five studies were included in the final review, comprising a total of 1043 cases. Two studies had a low risk for bias, two moderate, and one estimated to be high risk. The range of prevalence of asymptomatic CSCC in LSS in the five included studies was between 24% and 61%. Meta-analysis on the reported prevalence of asymptomatic CSCC patients with symptomatic LSS demonstrated that the random pooled prevalence was 35% (95% CI: 23 to 48).
Asymptomatic CSCC appears to occur in a high number of patients, with this study noting its presence in one-third of patients with LSS. Based on these findings, we strongly recommend that spine surgeons exercise particular caution during the positioning of patients who are undergoing surgery for lumbar stenosis. Furthermore, it is imperative to monitor individuals with symptomatic LSS closely for any potential signs of emerging myelopathy.
系统评价与荟萃分析。
本研究旨在确定腰椎管狭窄症（LSS）患者中无症状性颈脊髓压迫（CSCC）的患病率。
在Medline、EMBASE、Scopus和Web of Science数据库中进行系统的电子检索，无语言限制，起始日期无限制至2023年6月8日，以确定有症状的LSS患者中无症状性CSCC的患病率。无症状性CSCC根据影像学研究定义。纳入该综述的所有类型的研究。对报道的LSS患者无症状性CSCC的患病率进行荟萃分析。
数据库检索得到10272篇文章。经过全文审查，五项研究纳入最终综述，共1043例病例。两项研究偏倚风险低，两项中等，一项估计为高风险。五项纳入研究中LSS患者无症状性CSCC的患病率范围在24%至61%之间。对报道的有症状LSS患者无症状性CSCC患病率的荟萃分析表明，随机汇总患病率为35%（95%CI：23至48）。
大量患者似乎存在无症状性CSCC，本研究指出在三分之一的LSS患者中存在该情况。基于这些发现，我们强烈建议脊柱外科医生在为腰椎管狭窄症患者进行手术定位时格外谨慎。此外，密切监测有症状的LSS患者是否出现任何潜在的脊髓病迹象至关重要。
