World Neurosurg
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Review Meta Analysis
Predictable Risk Factors of Spontaneous Venous Thromboembolism in Patients Undergoing Spine Surgery.
The purpose of this study was to conduct a meta-analysis to identify the risk factors for formation of venous thromboembolism (VTE) in patients after spine surgery. ⋯ A higher rate of postoperative VTE is closely associated with the elderly, longer duration of surgery, thoracolumbar surgery, greater blood loss, and patients with a history of hypertension, preoperative walking disability, or diabetes after spinal surgery; these risk factors should be guarded against.
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Review Meta Analysis
Efficacy and Safety of Hypofractionated Stereotactic Radiotherapy for Recurrent Malignant Gliomas: A Systematic Review and Meta-analysis.
The current treatment for patients with relapsed malignant glioma (MG) remains unsatisfactory. Use of hypofractionated stereotactic radiotherapy (HFSRT) for recurrent MG has shown some encouraging results and may be a viable option. ⋯ The present evidence suggests that HFSRT is an efficacious and safe treatment approach to treat patients with recurrent MG. However, the retrospective and observational nature of the studies included in our systematic review and meta-analysis restricted formation of more solid conclusions. Thus, well-designed prospective controlled trials are warranted to further define the therapeutic role of HFSRT for recurrent MG.
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Review Meta Analysis
A systematic review and meta-analysis of perioperative parameters in robot-guided, navigated, and freehand thoracolumbar pedicle screw instrumentation.
Robotic guidance (RG) and navigation (NV) have been shown to reduce radiologic and clinically relevant pedicle screw malpositions. It remains unknown if there are any additional benefits to these techniques in intraoperative and perioperative end points. ⋯ It seems that navigation may offer potential benefits in perioperative outcomes such as length of hospital stay and overall complications, without significant increase in intraoperative radiation, which cannot yet be said for robotic guidance. The findings must be interpreted with caution, because the evidence is severely limited in both quantity and quality. Further evaluation will establish any demonstrable intraoperative or perioperative benefits to computer assistance, which may warrant the high costs often associated with these devices.
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Review Meta Analysis
Effectiveness of Sealants in Prevention of CSF Leakage after Spine Surgery: a Systematic Review.
Sealants are often used in spine surgery to prevent postoperative cerebrospinal fluid (CSF) leakage. ⋯ Currently available sealants seem not to reduce the rate of CSF leakage in spine surgery. In endoscopic and minimally invasive surgery, the CSF leakage rate is less frequent compared with open, conventional surgery regardless of sealant use.
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Review Meta Analysis
Association Between Supratotal Glioblastoma Resection and Patient Survival: A Systematic Review and Meta-Analysis.
Gross total resection (GTR) of the contrast enhancing (CE) area will improve the survival of patients with glioblastoma (GBM). However, GBM can infiltrate into the brain parenchyma, beyond the CE margins. It remains unclear whether resection beyond the CE area (supratotal resection [SPTR]) can improve survival without causing additional neurological deficits. The aim of the present meta-analysis was to study the association between SPTR and overall survival of patients of GBM. ⋯ Compared with GTR, SPTR of GBM resulted in a lower risk of mortality and longer median overall survival. However, the quality of evidence of the available studies was poor. Therefore, it remains unclear whether SPTR is safe and actually improves the survival of patients with GBM. Future prospective trials and a standardized definition of SPTR are needed.