Pooled analysis of non-union, re-operation, infection, and approach related complications after anterior odontoid screw fixation.
BACKGROUND: Anterior odontoid screw fixation (AOSF) has been one of the most popular treatments for odontoid fractures. However, the true efficacy of AOSF remains unclear. In this study, we aimed to provide the pooled rates of non-union, reoperation, infection, and approach related complications aft...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2014-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4109995?pdf=render |
| _version_ | 1819038187625906176 |
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| author | Nai-Feng Tian Xu-Qi Hu Li-Jun Wu Xin-Lei Wu Yao-Sen Wu Xiao-Lei Zhang Xiang-Yang Wang Yong-Long Chi Fang-Min Mao |
| author_facet | Nai-Feng Tian Xu-Qi Hu Li-Jun Wu Xin-Lei Wu Yao-Sen Wu Xiao-Lei Zhang Xiang-Yang Wang Yong-Long Chi Fang-Min Mao |
| author_sort | Nai-Feng Tian |
| collection | DOAJ |
| description | BACKGROUND: Anterior odontoid screw fixation (AOSF) has been one of the most popular treatments for odontoid fractures. However, the true efficacy of AOSF remains unclear. In this study, we aimed to provide the pooled rates of non-union, reoperation, infection, and approach related complications after AOSF for odontoid fractures. METHODS: We searched studies that discussed complications after AOSF for type II or type III odontoid fractures. A proportion meta-analysis was done and potential sources of heterogeneity were explored by meta-regression analysis. RESULTS: Of 972 references initially identified, 63 were eligible for inclusion. 54 studies provided data regarding non-union. The pooled non-union rate was 10% (95% CI: 7%-3%). 48 citations provided re-operation information with a pooled proportion of 5% (95% CI: 3%-7%). Infection was described in 20 studies with an overall rate of 0.2% (95% CI: 0%-1.2%). The main approach related complication is postoperative dysphagia with a pooled rate of 10% (95% CI: 4%-17%). Proportions for the other approach related complications such as postoperative hoarseness (1.2%, 95% CI: 0%-3.7%), esophageal/retropharyngeal injury (0%, 95% CI: 0%-1.1%), wound hematomas (0.2%, 95% CI: 0%-1.8%), and spinal cord injury (0%, 95% CI: 0%-0.2%) were very low. Significant heterogeneities were detected when we combined the rates of non-union, re-operation, and dysphagia. Multivariate meta-regression analysis showed that old age was significantly predictive of non-union. Subgroup comparisons showed significant higher non-union rates in age ≥ 70 than that in age ≤ 40 and in age 40 to <50. Meta-regression analysis did not reveal any examined variables influencing the re-operation rate. Meta-regression analysis showed age had a significant effect on the dysphagia rate. CONCLUSIONS/SIGNIFICANCES: This study summarized the rates of non-union, reoperation, infection, and approach related complications after AOSF for odontoid fractures. Elderly patients were more likely to experience non-union and dysphagia. |
| first_indexed | 2024-12-21T08:33:20Z |
| format | Article |
| id | doaj.art-b08293efc9754b94bc8d8ce8f7838d5b |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-21T08:33:20Z |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj.art-b08293efc9754b94bc8d8ce8f7838d5b2022-12-21T19:10:08ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0197e10306510.1371/journal.pone.0103065Pooled analysis of non-union, re-operation, infection, and approach related complications after anterior odontoid screw fixation.Nai-Feng TianXu-Qi HuLi-Jun WuXin-Lei WuYao-Sen WuXiao-Lei ZhangXiang-Yang WangYong-Long ChiFang-Min MaoBACKGROUND: Anterior odontoid screw fixation (AOSF) has been one of the most popular treatments for odontoid fractures. However, the true efficacy of AOSF remains unclear. In this study, we aimed to provide the pooled rates of non-union, reoperation, infection, and approach related complications after AOSF for odontoid fractures. METHODS: We searched studies that discussed complications after AOSF for type II or type III odontoid fractures. A proportion meta-analysis was done and potential sources of heterogeneity were explored by meta-regression analysis. RESULTS: Of 972 references initially identified, 63 were eligible for inclusion. 54 studies provided data regarding non-union. The pooled non-union rate was 10% (95% CI: 7%-3%). 48 citations provided re-operation information with a pooled proportion of 5% (95% CI: 3%-7%). Infection was described in 20 studies with an overall rate of 0.2% (95% CI: 0%-1.2%). The main approach related complication is postoperative dysphagia with a pooled rate of 10% (95% CI: 4%-17%). Proportions for the other approach related complications such as postoperative hoarseness (1.2%, 95% CI: 0%-3.7%), esophageal/retropharyngeal injury (0%, 95% CI: 0%-1.1%), wound hematomas (0.2%, 95% CI: 0%-1.8%), and spinal cord injury (0%, 95% CI: 0%-0.2%) were very low. Significant heterogeneities were detected when we combined the rates of non-union, re-operation, and dysphagia. Multivariate meta-regression analysis showed that old age was significantly predictive of non-union. Subgroup comparisons showed significant higher non-union rates in age ≥ 70 than that in age ≤ 40 and in age 40 to <50. Meta-regression analysis did not reveal any examined variables influencing the re-operation rate. Meta-regression analysis showed age had a significant effect on the dysphagia rate. CONCLUSIONS/SIGNIFICANCES: This study summarized the rates of non-union, reoperation, infection, and approach related complications after AOSF for odontoid fractures. Elderly patients were more likely to experience non-union and dysphagia.http://europepmc.org/articles/PMC4109995?pdf=render |
| spellingShingle | Nai-Feng Tian Xu-Qi Hu Li-Jun Wu Xin-Lei Wu Yao-Sen Wu Xiao-Lei Zhang Xiang-Yang Wang Yong-Long Chi Fang-Min Mao Pooled analysis of non-union, re-operation, infection, and approach related complications after anterior odontoid screw fixation. PLoS ONE |
| title | Pooled analysis of non-union, re-operation, infection, and approach related complications after anterior odontoid screw fixation. |
| title_full | Pooled analysis of non-union, re-operation, infection, and approach related complications after anterior odontoid screw fixation. |
| title_fullStr | Pooled analysis of non-union, re-operation, infection, and approach related complications after anterior odontoid screw fixation. |
| title_full_unstemmed | Pooled analysis of non-union, re-operation, infection, and approach related complications after anterior odontoid screw fixation. |
| title_short | Pooled analysis of non-union, re-operation, infection, and approach related complications after anterior odontoid screw fixation. |
| title_sort | pooled analysis of non union re operation infection and approach related complications after anterior odontoid screw fixation |
| url | http://europepmc.org/articles/PMC4109995?pdf=render |
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