World Neurosurg
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Review Meta Analysis Comparative Study
Percutaneous endoscopic lumbar discectomy versus posterior open lumbar microdiscectomy for the treatment of symptomatic lumbar disc herniation: a systemic review and meta-analysis.
The purpose of this systematic review and meta-analysis was to compare the clinical efficacy between percutaneous endoscopic lumbar discectomy (PELD) versus posterior open lumbar microdiscectomy (OLMD) for the treatment of symptomatic lumbar disc herniation. ⋯ Based on the present meta-analysis, no significant difference existed in VAS and ODI scores between the 2 surgical procedures, and they were also similar in terms of operation time, complication rate, and incidence of recurrence and reoperation, but PELD showed shorter hospital stay and time of return to work. Thus, under the premise of careful manipulation and complete decompression, we consider that PELD is a relatively more minimally invasive technique, which could be an alternative to OLMD.
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Resident education has to adapt to a changing health care environment. Although aspects such as working hours and attrition rates have been studied in detail, data about the residents' perspective, especially in European countries, are underrepresented in the scientific literature. The aim of this study was to assess and report aspects of neurosurgical education in German-speaking countries and to identify risk factors for quitting or changing the neurosurgical residency program. ⋯ The high attrition rate, especially among female residents, in Germany, Austria, and Switzerland should encourage program directors to specifically address the issues reported by this survey during interviews and to further improve their residency program accordingly.
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Review Meta Analysis Comparative Study
Carotid Artery Endarterectomy versus Carotid Artery Stenting for Patients with Contralateral Carotid Occlusion: A Systematic Review and Meta-Analysis.
Results from studies investigating the effect of contralateral carotid occlusion (CCO) in patients with carotid artery stenosis undergoing carotid artery endarterectomy (CEA) or carotid artery stenting (CAS) are variable in the literature. We sought to determine whether CEA or CAS is the optimal revascularization approach for patients with CCO. ⋯ Patients with CCO can safely undergo both CAS and CEA with similar risks of stroke, MI, and MACE. However, patients treated with CEA have a lower risk of 30-day periprocedural mortality. Future studies can help further clarify the ideal approach for these patients.
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Review Meta Analysis
Zero-Profile Versus Cage and Plate in Anterior Cervical Discectomy and Fusion with a Minimum 2 Years of Follow-Up: A Meta-Analysis.
In recent years, increasing numbers of cervical disease cases have been treated with zero-profile devices in anterior cervical discectomy and fusion (ACDF). Its short-term efficacy has been widely recognized; however, the evidence for long-term efficacy remains insufficient. The present study assessed the mid-term and long-term efficacy of zero-profile compared with cage and plate structures in ACDF by analyzing the clinical and radiological outcomes after treatment of cervical diseases with a minimum 2 years of follow-up. ⋯ The zero-profile and cage and plate structures achieved comparable mid-term and long-term clinical and radiological outcomes in ACDF. In addition, the zero-profile group showed reduced intraoperative blood loss, improved postoperative C2-C7 Cobb angle, and decreased incidence of dysphagia and adjacent segment degeneration complications.
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Review Meta Analysis Comparative Study
Glossopharyngeal neuralgia treatment outcomes following nerve section, microvascular decompression, or stereotactic radiosurgery: a systematic review and meta-analysis.
Glossopharyngeal neuralgia (GPN) is a rare neuralgic pain syndrome amenable to neurosurgical treatments, including nerve section (NS), microvascular decompression (MVD), and stereotactic radiosurgery (SRS). However, thorough comparisons of the modalities have not been performed to date. The objective of the present study was to compare the pain and complication outcomes after these approaches to GPN. ⋯ Neurosurgical treatment of GPN is frequently performed by 1 of 3 modalities with unique outcomes profiles. NS might provide the most favorable treatment response, with respect to short- and long-term pain relief and postoperative outcomes.