World Neurosurg
-
Review Meta Analysis
Modic changes increase the cage subsidence rate in spinal interbody fusion surgery: A systematic review and network meta-analysis.
To compare the effect of different Modic changes (MC) grades on the cage subsidence rate after spinal interbody fusion surgery. ⋯ MC may be associated with a higher cage subsidence rate. With the increase in MC grades, the incidence of subsidence decreased gradually, but it was always higher than that in the NMC. Oblique lumbar interbody fusion may be a better choice for the treatment of lumbar degenerative disease with MC.
-
Review Meta Analysis
Learning curve for endoscopic transsphenoidal surgery: A systematic review and meta-analysis.
Endoscopic transsphenoidal surgery (ETSS) is emerging as an effective, minimally invasive surgery technique for brain tumors of the pituitary fossa. Using a surgical endoscope, surgeons can obtain a broader, nearer, and more apparent visual field with minimal keyhole entrance. However, ETSS may require a steep learning curve to achieve technical competence and relevant outcomes. Moreover, there is no consensus on the learning process of ETSS. We aimed to review and determine the technical proficiency points of ETSS and discuss how to accelerate the learning curve. ⋯ ETSS is an efficient and minimally invasive alternative surgical option for pituitary tumors. Plateau points may differ according to outcome measures, patient selection, training status, and surgical conditions. Therefore, great care should be taken when interpreting the learning curve. A systematic training program is essential to improve the learning process of endoscopic neurosurgical procedures.
-
A meta-analysis of randomized controlled trials was conducted to assess efficacy and safety of bilateral ultrasound-guided erector spinae plane block (ESPB) for postoperative analgesia in patients receiving spine surgery. ⋯ Ultrasound-guided ESPB is an effective adjunctive technique with good tolerability for multimodal analgesia in management of pain in patients undergoing spine surgery.
-
Current management guidelines for the treatment of carotid stenosis are controversial. We performed this meta-analysis to evaluate the perioperative safety of carotid artery stenting (CAS) and endarterectomy. ⋯ The perioperative safety was equivalent between CAS and CEA. However, CEA may be preferred when considering both procedural safety and long-term efficacy in preventing recurrent stroke.