European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Review Meta Analysis
Surgical decompression timing for patients with foot drop from lumbar degenerative diseases: a meta-analysis.
To compare the outcomes of early (within 1 month after foot drop) decompression versus late (1 month or more after foot drop) decompression in order to determine the optimal surgical intervention timing for lumbar degenerative diseases. ⋯ Early surgical decompression within was beneficial in terms of recovery rate and neurological improvement compared with late surgery. Early surgical decompression (within 1 month) is recommended for patients with foot drop in lumbar degenerative diseases.
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Review Meta Analysis
Simultaneous decompression of all stenotic regions versus decompression of only the most symptomatic region in patients with tandem spinal stenosis: a systematic review and meta-analysis.
Selection of anatomic region of spine for decompression in patients with symptomatic tandem spinal stenosis (TSS) remains a challenge due to the confusing clinical presentation as well as uncertain evidence. A systematic review and meta-analysis of observational studies were conducted to compare the outcomes between simultaneous decompression of all stenotic regions (cervical and lumbar, Group 1) and decompression of only the most symptomatic stenotic region (cervical/lumbar, Group 2) in patients with TSS. ⋯ Decompression of the most symptomatic region alone irrespective of its location has equal clinical outcomes with less complication rate than simultaneous decompression in patients with TSS.
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Intradiscal vacuum phenomenon (IDVP), despite being ubiquitous, is poorly understood. The dynamic passage of peri-discal gases into the degenerated disc is a commonly accepted theory. But the reasons behind its selective appearance in some discs are unevaluated. ⋯ Modic disc-endplate contacts, ALL disruption and coronal translation could be pathways for the passage of peri-discal gases into the degenerated disc. In the pathogenesis of IDVP, advanced disc degeneration, the presence of pathways of gas transfer and angular/coronal instability seem to play complementary roles.
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The considered benefit of surgical drain use after spinal surgery is to prevent local accumulation of a haematoma by decompressing the closed space in the approach of the surgical site. In this context, the aim of the present systematic review was to prove the benefit of the routine use of closed-suction drains. ⋯ With regard to the existing literature, the use of closed-suction drainage in elective thoracolumbar spinal surgery is not associated with any proven benefit for patients and cannot decrease postoperative complications.