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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Meta Analysis Comparative Study
A meta-analysis of endoscopic discectomy versus open discectomy for symptomatic lumbar disk herniation.
The purpose of this study was to systematically compare the effectiveness and safety of endoscopic discectomy (ED) with open discectomy (OD) for the treatment of symptomatic lumbar disc herniation (LDH). ⋯ From the existing outcomes, ED surgery could be viewed as a sufficient and safe supplementation and alternative to standard open discectomy. The cost-effectiveness analyses still remain unproved from the existing data. More independent high-quality RCTs using sufficiently large sample sizes with cost-effectiveness analyses are needed.
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To evaluate the association between cigarette smoking and lumbar disc herniation (LDH). ⋯ This systematic review demonstrates that smoking promotes the development of LDH.
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To contrast the clinical and radiologic outcomes and adverse events of anterior cervical discectomy and fusion (ACDF) with a single cervical disc arthroplasty design, the polyurethane on titanium unconstrained cervical disc (PTUCD). ⋯ According to this review, PTUCD arthroplasty showed a global superiority to ACDF in clinical outcomes. The impact of both surgical techniques on the cervical spine (radiological spine deterioration and/or complications) was more severe in patients undergoing ACDF. However, the rate of revision surgeries at any cervical level was equivalent for ACDF and PTUCD arthroplasty.
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Meta Analysis
Prevalence of C5 nerve root palsy after cervical decompressive surgery: a meta-analysis.
To investigate the epidemiological prevalence of C5 palsy in patients following cervical decompressive surgery. ⋯ Cervical surgery is associated with high risk of C5 palsy, particularly in patients who received LIF and in male patients. These figures may be useful in the estimation of the probability of C5 palsy following cervical surgery.
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Degenerative lumbar scoliosis (DLS) is a spinal deformity that typically develops in adults over 50 years old. Although its etiology is unclear, asymmetric degeneration of the spine is the main cause. Individuals with DLS may experience no symptoms of the deformity, mild symptoms, or severe disability. Most patients with DLS receive conservative treatment, while a small number of patients receive surgery for severe DLS with back pain and/or progressive neurological symptoms. A variety of surgical procedures have emerged. However, a systemic comparison of these surgical procedures is currently unavailable. This study reviews the main outcomes and complications of surgical treatments. ⋯ Despite a high rate of complications, this review demonstrates that surgery is an effective and reasonable treatment intervention for severe DLS and ultimately improves spine function and deformity. This review also suggests that large scale, high quality studies with long term follow-up are needed to provide more reliable evidence for future evaluation.