World Neurosurg
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Review Meta Analysis
Epidural steroids at closure post-microdiscectomy/laminectomy for reduction of post-operative analgesia: systematic review and meta-analysis.
This review assessed the efficacy of epidural steroid administration on the reduction of pain, hospital stay time, and use of opioid analgesics postoperatively. ⋯ Intraoperative or perioperative epidural administration of steroids offers significant benefits in terms of pain control, reduction in LOS, and use of postoperative opioid analgesia. Before steroids are routinely used by spinal surgeons, however, significantly more research is required. A particular emphasis should be placed on quality study protocols and data recording, to allow for more thorough analyses in the future.
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Review Multicenter Study
Intraoperative monitoring of the integrity of the anterior visual pathways: a methodological review and meta-analysis.
Diverse methods have been developed for intraoperative monitoring of the integrity of the visual pathways. We performed a review of the literature to determine the methodology of each technique as well as their recent development. The predictive power of each eligible technique was determined based on a meta-analysis. ⋯ Each technique had limitations. Visual evoked potentials had a high predictive power for detection of deterioration but with low sensitivity. Fractional anisotropy of the optic chiasma had high predictive power for improvement of vision with low predictive power for deterioration.
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Review Meta Analysis
Decompressive craniectomy for spontaneous intracerebral hemorrhage: a systematic review and meta-analysis.
Spontaneous intracerebral hemorrhage (sICH) is a devastating disease with high mortality and morbidity, and the application of decompressive craniectomy (DC) in sICH is controversial. We conducted a systematic review to verify the effects of DC on improving outcome in sICH. ⋯ The application of DC effectively reduced mortality in patients with sICH. DC might improve functional outcomes in certain populations and needs further verification. DC is not associated with increased incidences of postoperative rebleeding and hydrocephalus.
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Review Meta Analysis
The Effect of Obesity on Clinical Outcomes Following Minimally Invasive Spine Surgery: A Systematic Review and Meta-analysis.
Obesity is associated with increasing morbidity and mortality in many prevalent diseases, especially lumbar degenerative disease. The relationship between minimally invasive surgery (MIS) of the spine and perioperative adverse events in obese patients with lumbar degenerative disease has not been well evaluated. ⋯ There does not seem to be an increased risk of developing perioperative complications in obese patients undergoing spine MIS. Spine MIS was a safe and effective technique for obese patients. However, according to our pooled data, longer surgery time was observed in obese patients.
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Review Case Reports
Pediatric non-missile penetrating head injury, case series and literature review.
Pediatric nonmissile penetrating head injury (NMPHI) is usually accidental attributed mainly to the softer skulls of growing children. However, it is a rare entity, and therefore no consensus exists regarding treatment to effectively prevent immediate and long-term complications. Throughout the literature, these injuries are mostly discussed in case reviews and case series in the general population. No data originating from randomized studies are available because of ethical and practical limitations. ⋯ In the last year, 4 literature reviews were published suggesting treatment algorithms of NMPHIs. Surgery timing and method as well as anticonvulsant and antibiotic therapy still remain debatable. The only review concentrating on pediatric populations dates back to 1994, based on patient outcome studies from the 1980s. In our review, treatment steps were similar among various institutions and resembled recently suggested algorithms, with better treatment outcomes than originally reported 30 years ago.