World Neurosurg
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Review Meta Analysis Comparative Study
Assessing the Difference in Clinical and Radiological Outcomes between Expandable Cage and Non-Expandable Cage among Patients undergoing MIS-TLIF: A Systematic Review and Meta-Analysis.
Minimally invasive transforaminal interbody fusion (MIS-TLIF) has been shown to have excellent outcomes for surgical management of degenerative disc disease. However, the challenge is in addressing coronal imbalance and restoring lumbar lordosis and sagittal alignment. Use of expandable cages in MIS-TLIF has been hypothesized to circumvent this disadvantage. An indirect meta-analysis of the evidence is presented comparing outcomes from expandable cages with those from nonexpandable cages, in patients undergoing MIS-TLIF. ⋯ Our results indicate that there may not be a significant difference in clinical and radiologic parameters between expandable cages and nonexpandable cages among patients undergoing MIS-TLIF, and it is unclear if the higher cost of the expandable cages is justified.
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Review Meta Analysis
Meta-analysis of the prognosis of Different treatments of symptomatic moyamoya disease.
The purpose of this study was to evaluate the efficacy of surgical revascularization versus conservative treatment and different surgical modalities, in order to provide evidence for the patient with moyamoya disease (MMD) to choose the appropriate treatment. ⋯ In patients with symptomatic moyamoya disease, bypass surgery is more effective than conservative treatment to prevent future strokes. In surgical patients, direct bypass seems to reduce the risk of stroke more than an indirect bypass.
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Review Case Reports Multicenter Study
Pipeline Embolization Device for the Treatment of Intracranial Pseudoaneurysms.
Intracranial pseudoaneurysms (PSAs) are associated with high rupture and mortality rates and have traditionally been treated by parent vessel sacrifice. There has been recent interest in using flow-diverting devices for treatment of these complex lesions while preserving flow through the parent artery. The objective of this study is to examine the safety and efficacy of these devices in the treatment of intracranial PSA. ⋯ In well-selected patients, the use of flow-diverting stents may be a feasible alternative to parent vessel sacrifice. Given the high morbidity and mortality associated with PSA, we recommend short- and long-term radiographic follow-up for patients treated with flow-diverting stents.
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Review Meta Analysis
Survival benefit of maximal resection for glioblastoma reoperation in the temozolomide era: a meta-analysis.
Although reoperation likely confers survival benefit for glioblastoma, whether the extent of resection (EOR) of the reoperation affects survival outcome has yet to be thoroughly evaluated in the current temozolomide (TMZ) era. The aim of this meta-analysis was to pool the current literature and evaluate the prognostic significance of reoperation EOR for glioblastoma recurrence in the current TMZ era. ⋯ In the current TMZ era, when reoperation is feasible for recurrent glioblastoma, maximal safe resection appears to confer a significant OS benefit based on the current literature. This benefit is most pronounced with radiographic GTR, and likely irrespective of EOR at index surgery.
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Review Meta Analysis
Efficacy and Safety of Hypofractionated Stereotactic Radiotherapy for Recurrent Malignant Gliomas: A Systematic Review and Meta-analysis.
The current treatment for patients with relapsed malignant glioma (MG) remains unsatisfactory. Use of hypofractionated stereotactic radiotherapy (HFSRT) for recurrent MG has shown some encouraging results and may be a viable option. ⋯ The present evidence suggests that HFSRT is an efficacious and safe treatment approach to treat patients with recurrent MG. However, the retrospective and observational nature of the studies included in our systematic review and meta-analysis restricted formation of more solid conclusions. Thus, well-designed prospective controlled trials are warranted to further define the therapeutic role of HFSRT for recurrent MG.