Anterior-Alone Surgical Treatment for Subaxial Cervical Spine Facet Dislocation: A Systematic Review
| Autor: | Wendy Xiao-Pin Lee, Chung Chek Wong |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_treatment
anterior cervical discectomy Zygapophyseal Joint Facet joint 03 medical and health sciences 0302 clinical medicine facet joint Fracture fixation medicine Orthopedics and Sports Medicine 030212 general & internal medicine Joint dislocation Surgical treatment Review Articles zygapophyseal joint Orthodontics business.industry cervical vertebrae medicine.disease Cervical spine inferior dislocation medicine.anatomical_structure Spinal fusion joint dislocations spinal fusion fracture fixation Surgery Neurology (clinical) business 030217 neurology & neurosurgery Cervical vertebrae |
| Zdroj: | Global Spine Journal |
| ISSN: | 2192-5690 2192-5682 |
| DOI: | 10.1177/2192568220907574 |
| Popis: | Study Design: Systematic review. Objective: Anterior-alone surgery has gained wider reception for subaxial cervical spine facets dislocation. Questions remain on its efficacy and safety as a stand-alone entity within the contexts of concurrent facet fractures, unilateral versus bilateral dislocations, anterior open reduction, and old dislocation. Methods: A systematic review was performed with search strategy using translatable MESH terms across MEDLINE, EMBASE, VHL Regional Portal, and CENTRAL databases on patients with subaxial cervical dislocation intervened via anterior-alone approach. Two reviewers independently screened for eligible studies. PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) flow chart was adhered to. Nine retrospective studies were included. Narrative synthesis was performed to determine primary outcomes on spinal fusion and revisions and secondary outcomes on new occurrence or deterioration of neurology and infection rate. Results: Nonunion was not encountered across all contexts. A total of 0.86% of unilateral facet dislocation (1 out of 116) with inadequate reduction due to facet fragments between the facet joints removed its malpositioned plate following fusion. No new neurological deficit was observed. Cases that underwent anterior open reduction did not encounter failure that require subsequent posterior reduction surgery. One study (N = 52) on old dislocation incorporated partial corpectomy in their approach and limited anterior-alone approach to cases with persistent instability. Conclusions: This systematic review supports the efficacy and success of anterior reduction, fusion, and instrumentation for cervical facet fracture dislocation. It is safe from a neurological standpoint. Revision rate due to concurrent facet fracture is low. Certain patients may require posteriorly based surgery or in specific cases combined anterior and posterior procedures. |
| Databáze: | OpenAIRE |
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