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The Prevalence of Asymptomatic Cervical Spinal Cord Compression in Individuals Presenting With Symptomatic Lumbar Spinal Stenosis: A Meta-Analysis Publisher



Farahbakhsh F1 ; Khosravi S1 ; Baigi V1, 2 ; Pourghahramani Koltapeh M1 ; Khayyamfar A1 ; Eskandari Z3 ; Ghodsi Z1, 4 ; Harrop J5 ; Rahimimovaghar V1, 4, 6, 7, 8
Authors
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Authors Affiliations
  1. 1. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Management, Faculty of Social Sciences and Economics, Alzahra University, Tehran, Iran
  4. 4. Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Division of Spine and Peripheral Nerve Surgery, Departments of Neurological and Orthopedic Surgery, Thomas Jefferson University, Philadelphia, PA, United States
  6. 6. Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Universal Scientific Education and Research Network (USERN), Tehran, Iran
  8. 8. Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran

Source: Global Spine Journal Published:2024


Abstract

Study Design: Systematic review and meta-analysis. Objective: The aim of this study was to determine the prevalence of asymptomatic cervical spinal cord compression (CSCC) in individuals with lumbar spinal stenosis (LSS). Methods: A systematic electronic search was conducted in Medline, EMBASE, Scopus, and Web of Science without language restriction, with no starting date limit to June 8, 2023, to define the prevalence of asymptomatic CSCC in symptomatic LSS patients. Asymptomatic CSCC was defined based on radiographic studies. All types of studies were included in the review. Meta-analysis was performed on the reported prevalence of asymptomatic CSCC in LSS. Results: The database search yielded 10,272 articles. After a full-text review, five studies were included in the final review, comprising a total of 1043 cases. Two studies had a low risk for bias, two moderate, and one estimated to be high risk. The range of prevalence of asymptomatic CSCC in LSS in the five included studies was between 24% and 61%. Meta-analysis on the reported prevalence of asymptomatic CSCC patients with symptomatic LSS demonstrated that the random pooled prevalence was 35% (95% CI: 23 to 48). Conclusions: Asymptomatic CSCC appears to occur in a high number of patients, with this study noting its presence in one-third of patients with LSS. Based on these findings, we strongly recommend that spine surgeons exercise particular caution during the positioning of patients who are undergoing surgery for lumbar stenosis. Furthermore, it is imperative to monitor individuals with symptomatic LSS closely for any potential signs of emerging myelopathy. © The Author(s) 2023.
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