Skrzypkowska, Paulina

OBJECTIVE Laminoplasty is a common treatment for cervical spondylotic myelopathy (CSM) and for ossification of the posterior longitudinal ligament (OPLL). However, approximately 21% of patients undergoing laminoplasty develop cervical kyphotic deformity (KD). Because of the high prevalence rate of KD, several studies have sought to identify predictors for this complication, but the findings remain highly inconsistent. Therefore, the authors performed a systematic review and meta-analysis to establish reliable preoperative predictors of KD. METHODS PubMed, Scopus, and Web of Science databases were used to systematically extract potential references. The first phase of screening required the studies to be written in the English language, involve patients treated for CSM and/or OPLL via laminoplasty, and report postoperative cervical KD. The second phase required the studies to provide more than 10 patients and include a control group. The mean difference (MD) and odds ratio (OR) were calculated for continuous and dichotomous parameters. Study quality was evaluated using the Newcastle-Ottawa Scale. CSM and OPLL patients were further assessed by performing subgroup analyses. RESULTS Thirteen studies comprising patients who developed cervical KD (n = 296) and no KD (n = 1254) after receiving cervical laminoplasty for CSM or OPLL were included in the meta-analysis. All studies were retrospective cohorts and were rated as high quality. In the combined univariate analysis of CSM and OPLL patients undergoing laminoplasty, statistically significant predictors for postoperative KD included age (MD 2.22, 95% CI 0.16–4.27, p = 0.03), preoperative BMI (MD 0.85, 95% CI 0.06–1.63, p = 0.04), preoperative C2–7 range of flexion (MD 10.42, 95% Cl 4.24–16.59, p = 0.0009), preoperative C2–7 range of extension (MD −4.59, 95% CI −6.34 to −2.83, p < 0.00001), and preoperative center of gravity of the head to the C7 sagittal vertical axis (MD 26.83, 95% CI 9.13–44.52, p = 0.003). Additionally, among CSM patients, males were identified as having a greater risk for postoperative KD (OR 1.73, 95% CI 1.02–2.93, p = 0.04). CONCLUSIONS The findings from this study currently provide the largest and most reliable review on preoperative predictors for cervical KD after laminoplasty. Given that several of the included studies identified optimal cutoff points for the variables that are significantly associated with KD, further investigation into the development of a preoperative risk scoring system that can accurately predict KD in the clinical setting is encouraged. PROSPERO registration no.: CRD42022299795 ( https://www.crd.york.ac.uk/PROSPERO/ ).

Purpose and methods: We surveyed a large sample of health-related sciences undergraduate students at the Medical University of Gdańsk (MUG), Poland in a pilot study to assess self-reported somatic/mental health-related issues, measure the level of burnout using Oldenburg Burnout Inventory (OLBI), the presence of depressive symptoms with Patient Health Questionnaire 9-item (PHQ-9) and assess the problematic alcohol intake (CAGE questionnaire). Additionally, stress coping mechanisms were investigated. Results: A total of 864 students participated in the survey. The mean total OLBI and PHQ-9 scores equalled 43.3 ± 2.7 and 11.3±5.8 points, respectively. The CAGE questionnaire was positive in 21.6% of students. Three most prevalent stress coping mechanisms included TV binge-watching, binge-eating and cigarette chain smoking (51.0%, 45.0% and 28.0% respectively). Conclusions: Future studies are required to confirm the obtained results, assess, and monitor trends and set-up interventions to improve the welfare of health-related science MUG students.