World Neurosurg
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Review Meta Analysis Comparative Study
Coiling is not superior to clipping in patients with high-grade aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.
Outcomes of coiling embolization versus clipping for patients with high-grade aneurysmal subarachnoid hemorrhage (aSAH) have not been previously compared. We reviewed current evidence regarding the safety and efficacy of clipping versus coiling for high-grade aSAH. ⋯ The outcome with coiling is not superior to clipping in patients with high-grade aSAH; moreover, coiling has a greater risk of mortality.
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Review Meta Analysis
Interventions for lumbar synovial facet joint cysts: a comparison of percutaneous, surgical decompression and fusion approaches.
Facet joint cysts (FJCs) of the lumbar spine are an increasingly reported cause of radiculopathy, lower back pain, and neurologic deficits. Currently, there is a lack of conclusive evidence outlining when a particular treatment should be undertaken and what patient indications suit a particular approach. The present systematic review and meta-analysis aims to evaluate the efficacy of percutaneous treatment and surgical decompression with or without fusion. ⋯ Evaluation of the literature shows surgical intervention to be advantageous over percutaneous procedures for the treatment of lumbar FJCs. There is no evidence suggesting when fusion should be undertaken because of the limited data available.
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Review Case Reports
Calcifying Pseudoneoplasm of the Neuraxis Arising from the Sacral Canal: A Case Report and Review of the Literature.
Calcifying pseudoneoplasm of the spine is an extremely rare lesion and has not yet been reported in the sacral canal. ⋯ Calcifying pseudoneoplasm of the neuraxis can occur throughout the spine, including the sacral canal, and should be included in the differential diagnosis of intraspinal calcified lesions.
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Multicenter Study Comparative Study
Patterns of stroke between university hospitals and non-university hospitals in mainland China: a prospective multicenter hospital-based registry study.
In China, stroke has risen to the first commonest cause of death. Currently published data on stroke come mainly from university hospitals and less from community hospitals, especially lacking information on stroke focusing on the differences between university hospitals and nonuniversity hospitals. Therefore we aimed to investigate the patterns and differences of acute stroke between university hospitals and nonuniversity hospitals in China. ⋯ This survey comparing stroke patients treated in university and nonuniversity hospitals in China showed that both cohorts were largely comparable including most demographic features, such as age and gender, history of stroke, and stroke subtypes. It may be concluded that patient cohorts treated on stroke units in university and nonuniversity hospitals are similar and stroke units in both types of institutions are also comparable in terms of workload and most patient outcomes.
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Despite widespread use of lumbar spinal fusion as a treatment for back pain, outcomes remain variable. Optimizing patient selection can help to reduce adverse outcomes. This literature review was conducted to better understand factors associated with optimal postoperative results after lumbar spinal fusion for chronic back pain and current tools used for evaluation. ⋯ This review summarizes current information and explains commonly used assessment tools to guide clinicians in decision making when caring for patients with lower back pain. When determining a treatment algorithm, physicians must consider predictive psychosocial factors. Use of perioperative cognitive-behavioral therapy and patient education can improve outcomes after lumbar spinal fusion.