Evidence map›Paper›PMID 34859269›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

Conundrum in surgical management of three-column injuries in sub-axial cervical spine: a systematic review and meta-analysis.

Siddharth Sekhar Sethy, Nikhil Goyal, Kaustubh Ahuja, Syed Ifthekar, Samarth Mittal, Gagandeep Yadav, P Venkata Sudhakar, Bhaskar Sarkar, Pankaj Kandwal

Abstract readMeta-AnalysisSystematic 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 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
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

7 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
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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

9 authors.

Siddharth Sekhar SethyDepartment of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, 249201, India.
Nikhil GoyalDepartment of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, 249201, India.
Kaustubh AhujaDepartment of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, 249201, India.
Syed IfthekarDepartment of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, 249201, India.
Samarth MittalDepartment of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, 249201, India.
Gagandeep YadavDepartment of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, 249201, India.
P Venkata SudhakarDepartment of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, 249201, India.
Bhaskar SarkarDepartment of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, 249201, India.
Pankaj KandwalDepartment of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, 249201, India. pankajkandwal27@gmail.com.ORCID http://orcid.org/0000-0002-8801-6909

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

designSystematic Review and Meta-analysis. PURPOSE: Three-column injuries making the spine unstable require adequate fixation which can be achieved by anterior alone, posterior alone or combined anterior-posterior approach. There is no general consensus till date on a single best approach in sub-axial cervical spine trauma. This study comparing the three approaches is an attempt to establish a firmer guideline in this disputed topic. MATERIAL AND

methodsThe protocol was registered with PROSPERO. PubMed, Embase and Google Scholar were searched for relevant literature. For each study, pre-defined data were extracted which included correction of kyphosis, loss of correction, hospital stay, operative time, blood loss during surgery as the outcome variables. Studies were also screened for the complications.

resultsEleven studies were evaluated for qualitative analysis and quantitative synthesis of the data in our review. The result demonstrated significant difference with most correction achieved in combined approach subgroup. Though no significant difference was found, the anterior group was having maximum loss of correction. Combined approach showed significantly more operative time and blood loss followed by posterior approach and then anterior approach alone. The improvement in VAS was significantly more in anterior subgroup when compared to combined approach.

conclusionCervical alignment is best restored by combined approach compared to the other two. Anterior only approach showed more correction than posterior approach. However, there is no significant difference between all three approaches in loss of correction at long-term follow-up. Anterior only approach is superior to posterior and combined approach on basis of intraoperative and perioperative parameters. LEVEL OF EVIDENCE I: Diagnostic: individual cross-sectional studies with the consistently applied reference standard and blinding.

Indexed as

Cervical VertebraeKyphosisCross-Sectional StudiesHumansNeckOperative TimeTreatment OutcomeAnterior approachCervical spineCombined approachPosterior approachSpine traumaThree-column injury

Identifiers

PMID34859269

What OpenQuestion holds

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Registered trials

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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.