Evidence map›Paper›PMID 34724109›Full record

SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2022

Should asymptomatic cervical stenosis be treated in the setting of progressive thoracic myelopathy? A systematic review of the literature.

Ehsan Dowlati, William Mualem, Jordan Black, Julisa Nuñez, Akanksha Girish, Islam Fayed, Kevin M McGrail, Jean-Marc Voyadzis

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Ehsan DowlatiDepartment of Neurosurgery, MedStar Georgetown University Hospital, 3800 Reservoir Rd. NW, PHC 7, Washington, DC, 20007, USA. edowlati@gmail.com.ORCID http://orcid.org/0000-0001-6739-0793
William MualemGeorgetown University School of Medicine, 3900 Reservoir Rd. NW, Washington, DC, USA.
Jordan BlackGeorgetown University School of Medicine, 3900 Reservoir Rd. NW, Washington, DC, USA.
Julisa NuñezGeorgetown University School of Medicine, 3900 Reservoir Rd. NW, Washington, DC, USA.
Akanksha GirishGeorgetown University School of Medicine, 3900 Reservoir Rd. NW, Washington, DC, USA.
Islam FayedDepartment of Neurosurgery, MedStar Georgetown University Hospital, 3800 Reservoir Rd. NW, PHC 7, Washington, DC, 20007, USA.
Kevin M McGrailDepartment of Neurosurgery, MedStar Georgetown University Hospital, 3800 Reservoir Rd. NW, PHC 7, Washington, DC, 20007, USA.
Jean-Marc VoyadzisDepartment of Neurosurgery, MedStar Georgetown University Hospital, 3800 Reservoir Rd. NW, PHC 7, Washington, DC, 20007, USA.
Georgetown University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeUnlike tandem stenosis of the cervical and lumbar spine, tandem cervical and thoracic stenosis (TCTS) of the spine is less common, and the approach and order of intervention are controversial. We aim to review the literature to evaluate the incidence and interventions for patients with cervical and thoracic stenosis. We provide illustrative cases to demonstrate that thoracic myelopathy in the setting of asymptomatic cervical stenosis can be treated safely.

methodsA systematic review of the literature through electronic databases of PubMed, EMBASE, Web of Science, and Cochrane Library was performed to present the current literature that evaluates TCTS as it relates to incidence and surgical interventions. We also present two cases of patients undergoing operative intervention for thoracic myelopathy in the setting of concurrent cervical stenosis.

resultsA total of 26 English original studies and case reports were identified. Nine studies evaluated the incidence of TCTS. 20 studies with a total of 168 patients with TCTS presented information on surgical intervention options. There is an overall aggregate incidence of 11.6% (530/4751) based on incidence studies. 165 patients underwent thoracic intervention. Of these patients, 63 patients underwent cervical intervention first, 29 underwent thoracic intervention first, and 73 underwent simultaneous, single-stage intervention.

conclusionsIn patients presenting with myelopathy, both cervical and thoracic spine should be evaluated for TCTS. Order of operative intervention is tailored to clinical and radiographic information. In cases of thoracic myelopathy with asymptomatic cervical stenosis, thoracic intervention can be pursued with precautions to prevent further cervical cord injury.

Indexed as

Spinal Cord DiseasesSpinal StenosisCervical VertebraeConstriction, PathologicHumansLumbar VertebraeCervicalLaminectomyMyelopathySpineStenosisTandem stenosisThoracic

Identifiers

PMID34724109
OpenAlexW3210559437

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.