World Neurosurg
-
Review Meta Analysis Comparative Study
Endovascular Mechanical Thrombectomy for Acute Ischemic Stroke Under General Anesthesia Versus Conscious Sedation: A Systematic Review and Meta-Analysis.
Endovascular mechanical thrombectomy (EMT) is the standard of care for eligible patients presenting with anterior circulation acute ischemic stroke (AIS) due to emergent large vessel occlusion (ELVO). The aim of this systematic review and meta-analysis is to compare the outcomes between patients undergoing general anesthesia (GA) versus conscious sedation (CS) for these procedures. ⋯ The use of either GA or CS during EMT for patients with anterior circulation acute ELVO does not yield significantly different rates of functional independence at 3 months.
-
Review Meta Analysis Comparative Study
Comparison Between Posterior Lumbar Interbody Fusion and Transforaminal Lumbar Interbody Fusion for the Treatment of Lumbar Degenerative Diseases: A Systematic Review and Meta-Analysis.
To compare the efficacy and safety in the management of lumbar diseases performed by either posterior lumbar interbody fusion (PLIF) or transforaminal lumbar interbody fusion (TLIF). Interbody fusion is considered the "gold standard" in the treatment of lumbar degenerative diseases. Both PLIF and TLIF have been advocated, and it remains controversial as to the best operative technique. ⋯ The available evidence suggests that both TLIF and PLIF could achieve similar clinical satisfaction and fusion rate in the management of degenerative lumbar diseases. However, TLIF was superior to PLIF with shorter operation time, less blood loss, and lower incidence of nerve root injury and dural tear. There is no significant difference between both groups regarding wound infection and graft malposition.
-
Review Meta Analysis
The Potential of Minimally Invasive Surgery to Treat Metastatic Spinal Disease versus Open Surgery: A Systematic Review and Meta-Analysis.
Metastasis to the spinal column is a common feature of primary tumors of the breast, prostate, lung, and other organs. Surgical intervention can be performed via the traditional open surgery (OS) approach or the minimally invasive surgery (MIS) approach. This study aims to assess the available evidence of perioperative outcomes of MIS versus OS for patients with metastatic spinal disease. ⋯ Surgical intervention by an MIS approach in patients with metastatic spinal disease seems to provide equivalent outcomes compared with OS and reduces morbidity and length of stay. Future studies that are larger, prospective, and longer-term will validate the findings of this study and elucidate the optimal role for MIS in the surgical management of metastatic spinal disease.
-
Review Comparative Study
Pain-Free Outcomes and Durability of Surgical Intervention for Trigeminal Neuralgia: A Comparison of Gamma Knife and Microvascular Decompression.
Treatment options for trigeminal neuralgia include microvascular decompression (MVD) and Gamma Knife surgery (GKS). There is no consensus which option is more effective at providing immediate and long-lasting pain relief. This study evaluated the differences between these 2 options in terms of rates of complete pain relief and pain-free recurrence. ⋯ MVD may be a more effective intervention than GKS owing to higher rates of initial pain-free outcomes and long-term pain-free outcomes. There is a need for more consistent data reporting of outcomes for treatment of trigeminal neuralgia.