Abdulrahman O Al-Naseem, Abdulaziz O Al-Naseem, Derek T Cawley, Ahmed Aoude, Anthony A Catanzano, Muhammad M Abd-El-Barr, Aman Sharma, Roozbeh Shafafy
{"title":"脊柱侧弯矫正手术中脊髓类型能否预测术中神经监测警报？手术和放射学预测因素的系统回顾和荟萃分析。","authors":"Abdulrahman O Al-Naseem, Abdulaziz O Al-Naseem, Derek T Cawley, Ahmed Aoude, Anthony A Catanzano, Muhammad M Abd-El-Barr, Aman Sharma, Roozbeh Shafafy","doi":"10.1177/21925682241237475","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>Systematic literature review and meta-analysis.</p><p><strong>Objectives: </strong>Predicting patient risk of intraoperative neuromonitoring (IONM) alerts preoperatively can aid patient counselling and surgical planning. Sielatycki et al established an axial-MRI-based spinal cord classification system to predict risk of IONM alerts in scoliosis correction surgery. We aim to systematically review the literature on operative and radiologic factors associated with IONM alerts, including a novel spinal cord classification.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines. A literature search identifying all observational studies comparing patients with and without IONM alerts was conducted. Suitable studies were included. Patient demographics, radiological measures and operative factors were collected.</p><p><strong>Results: </strong>11 studies were included including 3040 patients. Relative to type 3 cords, type 1 (OR = .03, CI = .01-.08, <i>P</i> < .00001), type 2 (OR = .08, CI = .03, <i>P</i> <.00001) and all non-type 3 cords (OR = .05, CI = .02-.16, <i>P</i> < .00001) were associated with significantly lower odds of IONM alerts. Significant radiographic measures for IONM alerts included coronal Cobb angle (MD = 10.66, CI = 5.77-15.56, <i>P</i> < .00001), sagittal Cobb angle (MD = 9.27, CI = 3.28-14.73, <i>P</i> = .0009), sagittal deformity angle ratio (SDAR) (MD = 2.76, CI = 1.57-3.96, <i>P</i> < .00001) and total deformity angle ratio (TDAR) (MD = 3.44, CI = 2.27-4.462, <i>P</i> < .00001). Clinically, estimated blood loss (MD = 274.13, CI = -240.03-788.28, <i>P</i> = .30), operation duration (MD = 50.79, CI = 20.58-81.00, <i>P</i> = .0010), number of levels fused (MD = .92, CI = .43-1.41, <i>P</i> = .0002) and number of vertebral levels resected (MD = .43, CI = .01-.84, <i>P</i> = .05) were significantly greater in IONM alert patients.</p><p><strong>Conclusions: </strong>This study highlights the relationship of operative and radiologic factors with IONM alerts.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418721/pdf/","citationCount":"0","resultStr":"{\"title\":\"Does Spinal Cord Type Predict Intraoperative Neuro-Monitoring Alerts in Scoliosis Correction Surgery? A Systematic Review and Meta-Analysis of Operative and Radiologic Predictors.\",\"authors\":\"Abdulrahman O Al-Naseem, Abdulaziz O Al-Naseem, Derek T Cawley, Ahmed Aoude, Anthony A Catanzano, Muhammad M Abd-El-Barr, Aman Sharma, Roozbeh Shafafy\",\"doi\":\"10.1177/21925682241237475\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study design: </strong>Systematic literature review and meta-analysis.</p><p><strong>Objectives: </strong>Predicting patient risk of intraoperative neuromonitoring (IONM) alerts preoperatively can aid patient counselling and surgical planning. Sielatycki et al established an axial-MRI-based spinal cord classification system to predict risk of IONM alerts in scoliosis correction surgery. We aim to systematically review the literature on operative and radiologic factors associated with IONM alerts, including a novel spinal cord classification.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines. A literature search identifying all observational studies comparing patients with and without IONM alerts was conducted. Suitable studies were included. Patient demographics, radiological measures and operative factors were collected.</p><p><strong>Results: </strong>11 studies were included including 3040 patients. Relative to type 3 cords, type 1 (OR = .03, CI = .01-.08, <i>P</i> < .00001), type 2 (OR = .08, CI = .03, <i>P</i> <.00001) and all non-type 3 cords (OR = .05, CI = .02-.16, <i>P</i> < .00001) were associated with significantly lower odds of IONM alerts. Significant radiographic measures for IONM alerts included coronal Cobb angle (MD = 10.66, CI = 5.77-15.56, <i>P</i> < .00001), sagittal Cobb angle (MD = 9.27, CI = 3.28-14.73, <i>P</i> = .0009), sagittal deformity angle ratio (SDAR) (MD = 2.76, CI = 1.57-3.96, <i>P</i> < .00001) and total deformity angle ratio (TDAR) (MD = 3.44, CI = 2.27-4.462, <i>P</i> < .00001). Clinically, estimated blood loss (MD = 274.13, CI = -240.03-788.28, <i>P</i> = .30), operation duration (MD = 50.79, CI = 20.58-81.00, <i>P</i> = .0010), number of levels fused (MD = .92, CI = .43-1.41, <i>P</i> = .0002) and number of vertebral levels resected (MD = .43, CI = .01-.84, <i>P</i> = .05) were significantly greater in IONM alert patients.</p><p><strong>Conclusions: </strong>This study highlights the relationship of operative and radiologic factors with IONM alerts.</p>\",\"PeriodicalId\":12680,\"journal\":{\"name\":\"Global Spine Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418721/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Global Spine Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/21925682241237475\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/3/1 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Global Spine Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/21925682241237475","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/3/1 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Does Spinal Cord Type Predict Intraoperative Neuro-Monitoring Alerts in Scoliosis Correction Surgery? A Systematic Review and Meta-Analysis of Operative and Radiologic Predictors.
Study design: Systematic literature review and meta-analysis.
Objectives: Predicting patient risk of intraoperative neuromonitoring (IONM) alerts preoperatively can aid patient counselling and surgical planning. Sielatycki et al established an axial-MRI-based spinal cord classification system to predict risk of IONM alerts in scoliosis correction surgery. We aim to systematically review the literature on operative and radiologic factors associated with IONM alerts, including a novel spinal cord classification.
Methods: A systematic review and meta-analysis was performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines. A literature search identifying all observational studies comparing patients with and without IONM alerts was conducted. Suitable studies were included. Patient demographics, radiological measures and operative factors were collected.
Results: 11 studies were included including 3040 patients. Relative to type 3 cords, type 1 (OR = .03, CI = .01-.08, P < .00001), type 2 (OR = .08, CI = .03, P <.00001) and all non-type 3 cords (OR = .05, CI = .02-.16, P < .00001) were associated with significantly lower odds of IONM alerts. Significant radiographic measures for IONM alerts included coronal Cobb angle (MD = 10.66, CI = 5.77-15.56, P < .00001), sagittal Cobb angle (MD = 9.27, CI = 3.28-14.73, P = .0009), sagittal deformity angle ratio (SDAR) (MD = 2.76, CI = 1.57-3.96, P < .00001) and total deformity angle ratio (TDAR) (MD = 3.44, CI = 2.27-4.462, P < .00001). Clinically, estimated blood loss (MD = 274.13, CI = -240.03-788.28, P = .30), operation duration (MD = 50.79, CI = 20.58-81.00, P = .0010), number of levels fused (MD = .92, CI = .43-1.41, P = .0002) and number of vertebral levels resected (MD = .43, CI = .01-.84, P = .05) were significantly greater in IONM alert patients.
Conclusions: This study highlights the relationship of operative and radiologic factors with IONM alerts.
期刊介绍：
Global Spine Journal (GSJ) is the official scientific publication of AOSpine. A peer-reviewed, open access journal, devoted to the study and treatment of spinal disorders, including diagnosis, operative and non-operative treatment options, surgical techniques, and emerging research and clinical developments.GSJ is indexed in PubMedCentral, SCOPUS, and Emerging Sources Citation Index (ESCI).
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