World Neurosurg
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Review Meta Analysis Comparative Study
Comparison of interventions for cervical ossification of posterior longitudinal ligament: a systematic review and network meta-analysis.
To summarize the literature and systematically evaluate outcomes for ossification of posterior longitudinal ligament interventions including anterior cervical corpectomy and fusion (ACCF), anterior controllable antedisplacement and fusion (ACAF), laminoplasty (LP), and laminectomy with fusion (LF). ⋯ Japanese Orthopaedic Association score outcomes indicated that ACCF was superior to LP and LF. ACAF had the largest cervical lordosis among all procedures. ACCF showed a higher incidence of overall complications compared with ACAF and LP.
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To determine whether vertical laminar fracture (VLF) can distinguish between AO type A3 and A4 fractures. ⋯ We found VLF to be highly specific, sensitive, and reliable in detecting A4 fractures. A higher proportion of A4 fractures with VLF had radiographic parameters and neurological deficit than A4 fractures with no VLF. VLF could be used as a severity modifier to further discriminate A3 and A4 fractures regarding severity and potentially guide treatment decision making.
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The clinical outcomes of balloon kyphoplasty (BKP) for split-type osteoporotic vertebral fractures (OVF) are poor. These may be owing to the vertebral body bifurcating anteriorly and posteriorly when a load is applied and the filled cement being unstable. We report the usefulness of BKP combined with pediculoplasty using cannulated screws (vertebra-pediculoplasty) for OVF with a risk of cement dislodgement. ⋯ Vertebra-pediculoplasty could be an effective method for managing OVF with a high risk of cement dislodgement, which has been difficult to treat using conventional BKP.
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Review Meta Analysis
Fluorescein-guided Resection of High Grade Gliomas: A Meta-Analysis.
High-grade gliomas (HGGs) have a poor prognosis despite current standard of care of surgery, chemotherapy, and radiation therapy. Achieving gross total resection (GTR) has been found to prolong survival in these patients. Intraoperative fluorescent agents are often used to aid in the resection of HGGs. One commonly used fluorescent agent is fluorescein sodium, which is U.S. Food and Drug Administration-approved for ocular surgeries and has a better side effect profile and is less costly than 5-aminolevulinic acid (5-ALA). In this meta-analysis, we provide statistical evidence of the efficacy in using fluorescein for HGG resection. ⋯ This meta-analysis shows that fluorescein-guided surgery improves GTR rates of HGGs when compared with non-fluorescence guided surgery and has similar GTR rates when compared with reported 5-ALA-guided resection rates.