The surgical treatment of subaxial acute cervical spine facet dislocations in adults: a systematic review and meta-analysis.

Autor: Botelho RV; Hospital Do Servidor Público Estadual de São Paulo, São Paulo, Brazil. bitbot@uol.com.br., de Freitas Bertolini E; Hospital Do Servidor Público Estadual de São Paulo, São Paulo, Brazil., Barcelos ACES; Division of Neurosurgery, University Hospital Lauro Wanderley/UFPB, João Pessoa, Paraíba, Brazil., Walter Daniel J; School of Medical Sciences, Santa Casa de São Paulo, São Paulo, Brazil., Fernandes Joaquim A; Department of Neurosurgery, UNICAMP, Campinas, São Paulo, Brazil., Dantas FLR; Biocor Instituto, Belo Horizonte, Minas Gerais, Brazil., Dantas F; Biocor Instituto, Belo Horizonte, Minas Gerais, Brazil., Onishi F; Department of Neurosurgery, Federal University of São Paulo, São Paulo, Brazil., Neto ER; Department of Neurosurgery, University of São Paulo, São Paulo, Brazil., Mudo ML; Universidade Cruzeiro Do Sul, São Paulo, Brazil., Buzetti Milano J; Brazilian Neurosurgical Society's Spine Department, Neurological Institute of Curiritba, Curitiba, Paraná, Brazil.
Jazyk: angličtina
Zdroj: Neurosurgical review [Neurosurg Rev] 2022 Aug; Vol. 45 (4), pp. 2659-2669. Date of Electronic Publication: 2022 May 21.
DOI: 10.1007/s10143-022-01808-1
Abstrakt: Adult cervical spine traumatic facet joint dislocations occur when excessive traumatic forces displace the vertebrae's facets, leading to loss of joint congruence. Reduction requires either cranial traction or open surgical procedures. This study aims to appraise the effects of different surgical techniques in the treatment of subaxial cervical spine acute traumatic facet blocks in adults. This study was based on a systematic literature review and meta-analysis, registered in Prospero (CRD42021279249). The PICO question was composed of adults with acute cervical spine traumatic facet dislocations submitted to anterior or posterior surgical approaches, associated or not with cranial traction for reduction. Each surgical technique was compared to the other. The primary clinical outcomes included neurological improvement or worsening and surgical success/failure rates. The anterior approach without cranial traction was efficient in reducing facet displacements. Skull traction was an efficient and immediate method to achieve spine dislocation reductions. Differences were not present among techniques regarding neurological improvement. There were no surgical failures in patients operated on via the posterior approach. The need to decompress and stabilize the cervical spine can be achieved by anterior or posterior surgical approaches, and there is no clear answer as to which initial approach is superior to the other.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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