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Review
. 2024 Apr;14(3):1052-1060.
doi: 10.1177/21925682231202776. Epub 2023 Sep 20.

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

Farzin Farahbakhsh  1 , Sepehr Khosravi  1 , Vali Baigi  1   2 , Masoud Pourghahramani Koltapeh  1 , Amirmahdi Khayyamfar  1 , Zahra Eskandari  3 , Zahra Ghodsi  1   4 , James Harrop  5 , Vafa Rahimi-Movaghar  1   4   6   7   8
Affiliations
Review

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

Farzin Farahbakhsh et al. Global Spine J. 2024 Apr.

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.

Keywords: asymptomatic; lumbar canal stenosis; magnetic resonance imaging; spinal cord compression; systematic review; tandem spinal stenosis.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flowchart of studies based on the PRISMA statement for the prevalence of asymptomatic cervical spinal cord compression in individuals presenting with symptomatic lumbar spinal stenosis.
Figure 2.
Figure 2.
Risk of bias assessment of included studies for the prevalence of asymptomatic cervical spinal cord compression in individuals presenting with symptomatic lumbar spinal stenosis.
Figure 3.
Figure 3.
Meta-analysis of the prevalence of asymptomatic cervical spinal cord compression (CSCC) in individuals with lumber spinal stenosis (LSS).
See this image and copyright information in PMC

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