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
The efficacy of conservative treatment of osteoporotic compression fractures on acute pain relief: a systematic review with meta-analysis.
The aim of this study is to systematically evaluate the efficacy of commonly used non-surgical treatments in acute care of adults with osteoporotic vertebral compression fractures (VCFs). ⋯ At present, there is insufficient evidence to inform conservative care for acute pain related to VCF. Large, multinational, placebo/sham-controlled trials to address this gap in evidence are needed.
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Meta Analysis Comparative Study
Comparison of unilateral versus bilateral pedicle screw fixation with cage fusion in degenerative lumbar diseases: a meta-analysis.
To compare the results between unilateral and bilateral pedicle screw (PS) fixation for the patients with degenerative lumbar diseases. ⋯ As compared to bilateral PS fixation with cage fusion, unilateral PS fixation with cage fusion achieves a similar VAS, ODI and SF-36 scores, fusion rate, complications and smaller surgical trauma. However, it is still uncertain whether unilateral pedicle screw fixation with cage fusion is as effective and safe as bilateral pedicle screw fixation with cage fusion.
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The study aims to evaluate the safety of balloon kyphoplasty in the treatment of painful osteoporotic vertebral compression fractures in Europe. ⋯ The safety profile and associated complications of balloon kyphoplasty shown in this analysis, based on the evidence provided by existing randomized controlled trials, can be of help to the practicing clinician who must contrast them with the potential benefits of the technique. These data represent an important step towards a balanced evaluation of the intervention though, a better reporting and more reliable data on long-term assessment of potential sequelae are needed.
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Review Meta Analysis
Intrawound vancomycin to prevent infections after spine surgery: a systematic review and meta-analysis.
Post-operative spine surgical site infections are associated with substantial morbidity, mortality, and economic burden. Intrawound vancomycin may prevent infections after spine surgery, but recent studies have reported conflicting results. The objectives of this systematic review and meta-analysis were to determine: (1) In patients undergoing spine surgery, does the application of intrawound vancomycin lead to reduced rates of post-operative surgical site infections? (2) Are there differences in the estimates of effect between observational studies and randomized trials? (3) What adverse events are reported in the literature? ⋯ There is a lack of high-quality evidence to inform the use of intrawound vancomycin in spine surgery. Surgeons should be cautious before widely adopting this intervention and should be vigilant in monitoring for adverse effects. Further investigation with additional randomized controlled trials is justified.
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Review Meta Analysis
Multi-level cervical disc arthroplasty (CDA) versus single-level CDA for the treatment of cervical disc diseases: a meta-analysis.
Cervical disc arthroplasty (CDA) was developed to treat cervical degenerated disc diseases with the advantages of preserving the kinematics of the functional spinal unit. However, the safety and reliability of multi-level CDA are still controverted when comparing to the single-level CDA. It has shown unclear benefits in terms of clinical results, functional recovery, heterotopic ossification, and the need for secondary surgical procedures. The purpose of this study is to estimate the effectiveness of multi-level cervical arthroplasty over single-level CDA for the treatment of cervical spondylosis and disc diseases. ⋯ The meta-analysis revealed that the outcomes and functional recovery of patients performed with multi-level CDA are equivalent to those with single-level CDA, which suggests the multi-level CDA is as effective and safe as single-level invention for the treatment of cervical spondylosis. Nonetheless, more well-designed studies with large groups of patients are needed to provide further evidence for the benefit and reliability of multi-level CDA in the treatment of cervical disc diseases.