Neurologic Disease Is a Risk Factor for Revision After Lumbar Spine Fusion

Development of a validated search filter for Ovid Embase for degenerative cervical myelopathy

BACKGROUND

Degenerative cervical myelopathy (DCM) is a recently proposed umbrella term for symptomatic cervical spinal cord compression secondary to degeneration of the spine. Currently literature searching for DCM is challenged by the inconsistent uptake of the term 'DCM' with many overlapping keywords and numerous synonyms.

OBJECTIVES

Here, we adapt our previous Ovid medline search filter for the Ovid embase database, to support comprehensive literature searching. Both embase and medline are recommended as a minimum for systematic reviews.

METHODS

References contained within embase identified in our prior study formed a 'development gold standard' reference database (N = 220). The search filter was adapted for embase and checked against the reference database. The filter was then validated against the 'validation gold standard'.

RESULTS

A direct translation was not possible, as medline indexing for DCM and the keywords search field were not available in embase. We also used the 'focus' function to improve precision. The resulting search filter has 100% sensitivity in testing.

DISCUSSION AND CONCLUSION

We have developed a validated search filter capable of retrieving DCM references in embase with high sensitivity. In the absence of consistent terminology and indexing, this will support more efficient and robust evidence synthesis in the field.

Acute Postoperative Bilateral Vocal Fold Paralysis After Posterior Spinal Correction for Dropped Head Syndrome

BACKGROUND

Acute bilateral vocal fold paralysis is a life-threatening complication that can occur during spinal surgery but has almost exclusively occurred with anterior approaches. Bilateral vocal fold paralysis after posterior spinal surgery has been exceedingly rare.

CASE DESCRIPTION

We present a case of acute postoperative dyspnea due to vocal fold paralysis requiring intubation and surgical intervention after posterior spinal correction for the treatment of dropped head syndrome. The patient had had a previous diagnosis of atypical Parkinson disease but was later diagnosed with multiple system atrophy.

CONCLUSIONS

We suggest that multiple system atrophy can result in an increased risk of bilateral vocal fold paralysis during surgical intervention of dropped head syndrome. Thus, our report could be of interest for those who perform spinal surgery in patients with neurological conditions.