Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Dec 2014
Review Meta Analysis Comparative StudyA meta-analysis of interlaminar minimally invasive discectomy compared to conventional microdiscectomy for lumbar disk herniation.
A meta-analysis was conducted to evaluate the evidence that compared the safety and efficacy of interlaminar minimally invasive discectomy (ILMI) and conventional microdiscectomy (MD) for treating lumbar disk herniation (LDH) patients and to develop GRADE based recommendations for using the procedures to treat LDH. Eleven studies, encompassing 1012 patients, met the inclusion criteria. Overall, the results of the meta-analysis indicated that there were significant differences between the two groups in blood loss (SMD=-0.93, 95% CI -1.84, -0.02; p=0.05), and the number of days stays in hospital (SMD=-0.79, 95% CI -1.55, -0.04; p=0.04). ⋯ Compared with MD, ILMI can shorten days in hospital, decrease the mounts of blood loss during surgery. However, the overall GRADE evidence quality was very low. Therefore, further validation is required, and medical institutions should conduct high-quality studies.
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Clin Neurol Neurosurg · Oct 2014
Review Meta AnalysisEffects of dexmedetomidine on outcomes following craniocerebral operation - a meta-analysis.
To evaluate the effect of dexmedetomidine on outcomes following craniocerebral operation and provide evidence for individualized medication. ⋯ Dexmedetomidine can reduce the hemodynamic response and play a role in brain protection.
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Clin Neurol Neurosurg · Feb 2014
Review Meta AnalysisUnilateral versus bilateral pedicle screw fixation in lumbar interbody fusion: a meta-analysis of complication and fusion rate.
Unilateral or bilateral pedicle screw (PS) fixation in lumbar interbody fusion remains controversial. The aim of this study was to evaluate the complication and fusion rate for both surgical techniques based on published studies. Pubmed, Cochrane Library and Embase Databases were searched to identify studies reporting complication rate or fusion rate of unilateral and bilateral PS fixation in lumbar interbody fusion. ⋯ However, the fusion cage migration rate was significant higher (RR 2.41, 95% CI: 1.06-5.46, P=0.04) in unilateral group than bilateral group. In conclusion, the available evidence indicated that both unilateral PS fixation and bilateral PS fixation could get satisfactory fusion rate and complication rate. But unilateral PS fixation had more fusion cage migration than bilateral PS fixation in patients who undergo lumbar interbody fusion.
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Clin Neurol Neurosurg · May 2013
Review Meta AnalysisWhat is the best treatment of drug-resistant trigeminal neuralgia in patients affected by multiple sclerosis? A literature analysis of surgical procedures.
Drug-resistant trigeminal neuralgia (TN) can complicate the clinical course of patients affected by multiple sclerosis (MS). Various surgical procedures have been reported for the treatment of this condition, but there is no agreement on the best management of these patients. To our knowledge, there is no critical literature analysis focusing on this particular topic. The aim of this study was to evaluate the clinical outcome of different surgical procedures utilized for drug-resistant TN in MS patients. ⋯ Our study shows no differences in the short term results among different procedures for TN in MS patients. Each technique demonstrate advantages and limits in terms of long term pain, recurrence rate and complication rate. Each patient should be accurately informed on pros and cons of each procedure in order to be involved in the most appropriate choice.
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Clin Neurol Neurosurg · Feb 2013
Review Case Reports Meta AnalysisPannus regression after posterior decompression and occipito-cervical fixation in occipito-atlanto-axial instability due to rheumatoid arthritis: case report and literature review.
Several techniques have been proposed for treating cervical spine instability due to rheumatoid arthritis. The aim of this study was to screen the different treatment options used in this pathology to evaluate the best form of treatment when the progression of rheumatoid disease affected the cranio-vertebral junction (CVJ) stability. The most important purpose of this study was to achieve both the efficacy of occipito-cervical fusion (OCF) to stabilize the occipitocervical junction and stop pannus progression. The authors describe their case example and stress, in the light of a literature review, the hypothesis that a stable biomechanical system extended to all the spaces involved, has both direct and indirect effects on RA pannus progression and the condition responsible for its formation, such as inflammation and articular hypermobility. Hence, the aim of this study is to advance this thesis, which may be extended to a wider statistical sample, with the same characteristics. ⋯ Thirty-seven different studies were identified that reflected search criteria, five of which were literature reviews. The different surgical treatment options in cervical RA disease are described in relation to neurological outcome according to the Ranawat grading system, functional outcome or quality of life according to the Steinbrocker classification, and progression of cervical instability and radiographic index of cranial settling, focusing on the role of OCF.