European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Review Meta Analysis
Clinical course of pain and disability following primary lumbar discectomy: systematic review and meta-analysis.
To conduct a meta-analysis to describe clinical course of pain and disability in adult patients post-lumbar discectomy (PROSPERO: CRD42015020806). ⋯ Moderate-level evidence supports clinically relevant immediate improvement in leg pain and disability following lumbar discectomy with accompanying improvements in back pain. These slides can be retrieved under Electronic Supplementary Material.
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The five-repetition sit-to-stand (5R-STS) test was designed to capture objective functional impairment and thus provided an adjunctive dimension in patient assessment. The clinical interpretability and confounders of the 5R-STS remain poorly understood. In clinical use, it became apparent that 5R-STS performance may differ between patients with lumbar disk herniation (LDH), lumbar spinal stenosis (LSS) with or without low-grade spondylolisthesis, and chronic low back pain (CLBP). We seek to evaluate the extent of diagnostic information contained within 5R-STS testing. ⋯ 5R-STS performance differs according to the etiology of back and leg pain, even after adjustment for demographic covariates. In combination with machine learning algorithms, OFI can be used to infer the etiology of spinal back and leg pain with accuracy comparable to other diagnostic tests used in clinical examination. These slides can be retrieved under Electronic Supplementary Material.
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Review Meta Analysis
Complication rates of different discectomy techniques for symptomatic lumbar disc herniation: a systematic review and meta-analysis.
This meta-analysis aims to compare the complication rates of discectomy/microdiscectomy (OD/MD), microendoscopic discectomy (MED), percutaneous endoscopic lumbar discectomy (PELD), percutaneous laser disc decompression (PLDD), and tubular discectomy for symptomatic lumbar disc herniation (LDH) using general classification and modified Clavien-Dindo classification (MCDC) schemes. ⋯ Compared with the OD/MD, results of this meta-analysis suggest that PELD has a lower risk of overall complications and a lower risk of complications necessitating conservative treatment. These slides can be retrieved under Electronic Supplementary Material.
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Review Meta Analysis
A systematic review and meta-analysis on the management of accidental dural tears in spinal surgery: drowning in information but thirsty for a clear message.
To systematically review the published techniques for dural tear (DT) repair in spinal surgery to determine the repair method associated with the lowest failure rate. ⋯ Direct repair was associated with low proportion of failure. Howver, the approach to DT treatment was commonly determined on an ad hoc basis according to surgeons' preferences, and few followed defined management protocols. Future studies reporting DT treatment ought to categorise the treatment outcome according to the complexity of the DT and the specific treatment used, thus improving research quality in the field.
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Meta Analysis Comparative Study
A meta-analysis of the safety and effectiveness of titanium mesh versus bone graft alone for the treatment of thoracolumbar tuberculosis.
The aim of this study is to investigate, using a meta-analysis, differences in safety and effectiveness between a titanium mesh bone graft and bone graft alone for the treatment of thoracolumbar spinal tuberculosis. ⋯ Both titanium mesh and bone grafts alone are effective for the treatment of thoracolumbar spinal tuberculosis based on safety. However, the results of this study do not support the superiority of titanium mesh bone grafts reported in previous studies. Because of the high risk of bias of the conclusions of a meta-analysis of non-randomized studies and the small sample sizes for some of the most important outcomes, randomized controlled trials are expected to further examine the reliability of the present findings.