Complications associated with subaxial placement of pedicle screws versus lateral mass screws in the cervical spine (C2-T1): systematic review and meta-analysis comprising 4,165 patients and 16,669 screws.

Autor: Soliman MAR; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA.; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, NY, USA.; Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt., Aguirre AO; Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA., Khan S; Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA., Kuo CC; Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA., Ruggiero N; Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA., Mariotti BL; Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA., Fritz AG; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA.; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, NY, USA., Sharma S; Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA., Nezha A; Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA., Levy BR; School of Medicine and Health Sciences, George Washington University, Washington, DC, USA., Khan A; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA.; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, NY, USA., Salem AA; Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt., Jowdy PK; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA.; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, NY, USA., Zeeshan Q; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA.; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, NY, USA., Ghannam MM; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA.; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, NY, USA., Starling RV; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA.; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, NY, USA., Rho K; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA.; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, NY, USA., Pollina J; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA.; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, NY, USA., Mullin JP; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, NY, USA. jmullin@ubns.com.; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, NY, USA. jmullin@ubns.com.
Jazyk: angličtina
Zdroj: Neurosurgical review [Neurosurg Rev] 2023 Feb 28; Vol. 46 (1), pp. 61. Date of Electronic Publication: 2023 Feb 28.
DOI: 10.1007/s10143-023-01968-8
Abstrakt: Lateral mass screw (LMS) and cervical pedicle screw (CPS) fixation are among the most popular techniques for posterior fusion of the cervical spine. Early research prioritized the LMS approach as the trajectory resulted in fewer neurovascular complications; however, with the incorporation of navigation assistance, the CPS approach should be re-evaluated. Our objective was to report the findings of a meta-analysis focused on comparing the LMS and CPS techniques in terms of rate of various complications with inclusion of all levels from C2 to T1. We conducted a systematic review of PubMed and EMBASE databases with final inclusion criteria focused on identifying studies that reported outcomes and complications for either the CPS or LMS technique. These studies were then pooled, and statistical analyses were performed from the cumulative data. A total of 60 studies comprising 4165 participants and 16,669 screws placed within the C2-T1 levels were identified. Within these studies, the LMS group had a significantly increased odds for lateral mass fractures (odds ratio [OR] = 43.2, 95% confidence interval [CI] = 2.62-711.42), additional cervical surgeries (OR = 5.56, 95%CI = 2.95-10.48), and surgical site infections (SSI) (OR = 5.47, 95%CI = 1.65-18.16). No other significant differences between groups in terms of complications were identified. Within the subgroup analysis of navigation versus non-navigation-guided CPS placement, no significant differences were identified for individual complications, although collectively significantly fewer complications occurred with navigation (OR = 5.29, 95%CI = 2.03-13.78). The CPS group had significantly fewer lateral mass fractures, cervical revision surgeries, and SSIs. Furthermore, navigation-assisted CPS placement was associated with a significant reduction in complications overall.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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