Risk Factors for Failure of Non-operative Management in Isolated Unilateral Non-displaced Facet Fractures of the Subaxial Cervical Spine: Systematic Review and Meta-Analysis

被引:0
作者
Cirillo, Ignacio [1 ,2 ,3 ]
Ricciardi, Guillermo Alejandro [4 ,5 ,6 ]
Cabrera, Juan Pablo [7 ,8 ]
Lopez Munoz, Felipe [1 ]
Romero Valverde, Lyanne [4 ]
Joaquim, Andrei [9 ]
Carazzo, Charles [10 ]
Yurac, Ratko [11 ,12 ]
机构
[1] Hosp Trabajador, Santiago, Chile
[2] Clin Univ Los Andes, Santiago, Chile
[3] Univ Andres Bello, Hosp Trabajador, Fac Med, Santiago, Chile
[4] Sanat Guemes, BUENOS AIRES, Argentina
[5] Ctr Med Integral Fitz Roy, Buenos Aires, Argentina
[6] HOSP GEN AGUDOS DR TEODORO ALVAREZ, BUENOS AIRES, Argentina
[7] Hosp Clin Reg Concepcion, Dept Neurosurg, CONCEPCION, Chile
[8] Univ Concepcion, Fac Med, CONCEPCION, Chile
[9] Univ Campinas Unicamp, Campinas, Brazil
[10] Univ Passo Fundo, Passo Fundo, Brazil
[11] Univ del Desarrollo, Concepcion, Chile
[12] Clin Alemana, Dept Traumatol, Spine Unit, Santiago, Chile
关键词
trauma; facet fracture; isolated; risk factors; failure; non operative; LATERAL MASS; INJURIES; CLASSIFICATION; DISLOCATIONS; OUTCOMES; JOINT;
D O I
10.1177/21925682241304351
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Design systematic review.Objective To evaluate risk factors associated with failure of non-operative management of isolated unilateral facet fractures of the subaxial cervical spine in neurologically intact patients.Methods A systematic review of the PubMed, Embase, LILACS, and Cochrane Library databases was conducted in order to determine risk factors associated with failure of non-operative management in isolated unilateral facet fractures of the subaxial cervical spine without facet and/or vertebral displacement, in neurologically intact patients. Our research was in line with the PRISMA Statement and registered on PROSPERO (CRD42023405699).Results A total of 1639 studies were identified through a database search on May 5, 2023. In total, 7 studies from the databases were included, along with 1 study found through a manual citation search. The evidence showed high clinical heterogeneity, a serious risk of bias according to the ROBINS-I tool, and a predominance of retrospective cohort studies. In comparison to less complex facet fractures, lateral floating mass fractures were found to have 5.41 times higher odds of failure of non-operative management (OR = 5.41; 95% CI = 1.32, 22.19). We calculated the potential association between lower absolute fracture height and non-operative treatment success [Fracture height (percentage) Mean Difference = -17.51 (-28.22, -6.79 95% CI); Absolute height Mean Difference: -0.46 (-0.60, -0.31 95% CI)]. Other risk factors were not included in the meta-analysis due to lack of data. The level of certainty was rated as "very low".Conclusions Lateral floating mass cervical facet fractures and larger fracture fragment size (measured either in absolute terms or as a percentage) are significant risk factors for failure of non-operative treatment.
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页码:2467 / 2479
页数:13
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