Risk of the high-riding variant of vertebral arteries at C2 is increased over twofold in rheumatoid arthritis: a meta-analysis
Autor: | Leszek Sagan, Jagoda Cembik, Tomasz Klepinowski |
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Rok vydání: | 2020 |
Předmět: |
Joint Instability
medicine.medical_specialty Vertebral artery Review Group A Group B Arthritis Rheumatoid Craniocervical fusion Risk Factors Internal medicine medicine.artery Medicine Humans Risk factor Rheumatoid arthritis Vertebral Artery High-riding vertebral artery Atlantooccipital dislocation business.industry General Medicine medicine.disease Atlantoaxial dislocation Meta-analysis Atlanto-Axial Joint Relative risk Surgery Neurology (clinical) business Cohort study |
Zdroj: | Neurosurgical Review |
ISSN: | 1437-2320 |
Popis: | Rheumatoid arthritis (RA) might lead to atlantoaxial instability requiring transpedicular or transarticular fusion. High-riding vertebral artery (HRVA) puts patients at risk of injuring the vessel. RA is hypothesized to increase a risk of HRVA. However, to date, no relative risk (RR) has been calculated in order to quantitatively determine a true impact of RA as its risk factor. To the best of our knowledge, this is the first attempt to do so. All major databases were scanned for cohort studies combining words “rheumatoid arthritis” and “high-riding vertebral artery” or synonyms. RA patients were qualified into the exposed group (group A), whereas non-RA subjects into the unexposed group (group B). Risk of bias was explored by means of Newcastle-Ottawa Scale. MOOSE checklist was followed to ensure correct structure. Fixed-effects model (inverse variance) was employed. Four studies with a total of 308 subjects were included in meta-analysis. One hundred twenty-five subjects were in group A; 183 subjects were in group B. Mean age in group A was 62,1 years, whereas in group B 59,9 years. The highest risk of bias regarded “comparability” domain, whereas the lowest pertained to “selection” domain. The mean relative risk of HRVA in group A (RA) as compared with group B (non-RA) was as follows: RR = 2,11 (95% CI 1,47–3,05), I2 = 15,19%, Cochrane Q = 3,54 with overall estimate significance of p |
Databáze: | OpenAIRE |
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