World Neurosurg
-
Meta Analysis
Mechanical Thrombectomy for M2 Segment Occlusion in Acute Ischemic Stroke：a systematic review and meta analysis.
The safety and benefit of mechanical thrombectomy (MT) in the treatment of acute ischemic stroke (AIS) patients with M2 segment middle cerebral artery occlusions remain uncertain. ⋯ Compared with M1 occlusion, patients with M2 occlusion treated by MT demonstrated similar clinical outcomes in this study. Moreover, there was no difference between stent retriever and aspiration in treating M2 occlusion in terms of functional independence at 90 days. However, aspiration exerted a conspicuously higher recanalization rate in M2 occlusion than in M1 occlusion.
-
Red blood cell (RBC) transfusion is commonly indicated in brain tumor surgery due to risk of blood loss. Current transfusion guidelines are based on evidence derived from critically ill patients and may not be optimal for brain tumor surgeries. Our study is the first to synthesize available evidence to suggest RBC transfusion thresholds in brain tumor patients undergoing surgery. ⋯ A restrictive Hb threshold of 8 g/dL appears to be safe and minimizes potential complications of transfusion in brain tumor patients.
-
Vestibular schwannomas are benign, slow-growing tumors that often reduce patient quality of life by compressing nearby nerves. Neurological function preservation is one of the indicators of treatment success, with hearing preservation being the most difficult to obtain. This paper provides a bibliometric analysis of hearing preservation in treating acoustic neuromas and a greater understanding of the most highly cited articles, which have enhanced our understanding of this topic. ⋯ Bibliometric analyses summarize and assess potential areas of strength and knowledge gaps within the literature. Studies on hearing preservation in vestibular schwannomas mostly consist of retrospective reviews that assess postoperative outcomes of microsurgery and radiosurgery. Prospective studies and novel treatment options for hearing preservation in vestibular schwannomas are needed to increase current literature diversity.
-
Lateral lumbar interbody fusion (LLIF) and percutaneous posterior screw fixation (PPSF) techniques is used to treat degenerative lumbar pathologies. Dual-position (DP) lumbar surgery involves repositioning the patient from the supine or lateral decubitus position to prone for posterior fixation. Single-position (SP) lumbar surgery is commonly performed nowadays, a minimally invasive alternative performed entirely from the lateral decubitus position. However, controversy still exists. This meta-analysis aimed to compare perioperative outcomes between SP lumbar surgery and DP lumbar surgery for LLIF and PPSF. ⋯ This meta-analysis found that SP have lower operative time and length of hospital stay compared with DP LLIF and PPSF. However, no differences in intraoperative blood loss, radiation dose, radiographic change, complications, and reoperation rates were found.
-
Multicenter Study
Neurosurgery subspecialty practice during a pandemic: a multicenter analysis of operative practice in 7 U.S. neurosurgery departments during COVID-19.
Changes to neurosurgical practices during the coronavirus disease 2019 (COVID-19) pandemic have not been thoroughly analyzed. We report the effects of operative restrictions imposed under variable local COVID-19 infection rates and health care policies using a retrospective multicenter cohort study and highlight shifts in operative volumes and subspecialty practice. ⋯ Operative restrictions during the COVID-19 surge led to distinct shifts in neurosurgical practice, and local infective burden played a significant role in operative volume and patient acuity.