• Yasoda Satpathy, Pishtiwan Ahmaki, Jubran H Jubran, Joseph D Ciacci, David R Santiago-Dieppa, Martin H Pham, Alexander A Khalessi, and Brian R Hirshman.
• Department of Neurosurgery, University of California San Diego School of Medicine, La Jolla, California, USA.
• World Neurosurg. 2025 Feb 3; 195: 123611123611.

BackgroundCervical stenosis (CS) is the pathologic narrowing of the central canal of the cervical spine. It is often incidentally discovered. It is unclear whether pre-existing CS can lead to worse outcomes and higher incidences of post-traumatic spinal cord injury (SCI).MethodsWe conducted a systematic review and meta-analysis of studies collected using the keywords "cervical stenosis" AND ("trauma" OR "injury"). About 381 articles were collected from PubMed, Embase, and Cochrane, and 2675 patients from 7 studies were included in the final analyses. Neo-Bayesian statistics were used to estimate a number needed to treat.ResultsIn a meta-analysis of studies with internal controls, patients with pre-existing CS are not at a higher risk of post-traumatic SCI (odds ratio 2.73, 95% confidence interval [CI] 0.78-9.50). However, CS patients have a greater incidence of SCI (0.41, 95% CI 0.26-0.56) compared to patients without CS (0.18, 95% CI 0.14-0.22). Patients with CS were also over-represented in the population of SCI patients (0.46, 95% CI 0.27; 0.65). Using neo-Bayesian statistics, we estimate that 70 patients with CS must be treated to prevent one SCI. In patients who participate in higher-risk physical activities, the number needed to treat may be lower.ConclusionsThough patients with pre-existing CS do not have higher odds of SCI in studies with internal controls, we find that patients with CS do have higher incidences of SCI and are over-represented in the population of SCI patients. In select CS patients with active lifestyles, close follow-up and consideration of various treatment options may be indicated.Copyright © 2024. Published by Elsevier Inc.

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