World Neurosurg
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To compare the treatment results between 1-level vertebral column decancellation (VCD) and pedicle subtraction osteotomy (PSO) for correcting severe kyphotic deformity in ankylosing spondylitis (AS). VCD and PSO have been used to correct AS-related kyphotic deformity, but the differences on correcting results between VCD and PSO are not clear. ⋯ VCD is a safe and effective method in treating rigid kyphotic deformity secondary to AS. VCD provides a larger correction angle in one segment and preserves more height of osteotomized vertebrae than PSO.
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The treatment strategies of ruptured intracranial aneurysms (RIAs) include surgical clipping and endovascular coiling, and the efficacy and safety of clipping versus coiling are yet controversial. ⋯ This meta-analysis provides moderate evidence that surgical clipping has few benefits than endovascular coiling for the treatment of RIA.
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The use of mechanical thrombectomy for the treatment of acute ischemic stroke (AIS) is rapidly increasing. However, there are limited data on the comparative effects of the various devices approved by the U.S. Food and Drug Administration for the treatment of AIS. We aimed to perform a network meta-analysis to assess the relative efficacy and safety of 4 thrombectomy devices. ⋯ We concluded that stent retriever devices were superior to non-stent retriever devices in functional outcomes and recanalization without significant increases in death or symptomatic hemorrhage. We found no evidence for a differential therapy effect by stent type. Further high-quality RCTs assessing efficacy difference between these 2 stent retrievers are justified.
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We describe a modified endoscopic diving technique with an alternative irrigation system different than the one used by Locatelli et al. (CLEARVISION II, Karl Storz and Co., Tuttlingen, Germany). ⋯ The use of the modified endoscopic diving technique allows surgeons to have more settings that could be controlled and also bypasses any compatibility issues between different endoscopic systems. In addition, the reproducibility of this technique, together with the low cost of the instrumentation, could allow an easier application of the diving technique.
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Neuronal apoptosis plays a pivotal role in spinal cord injury (SCI)-induced secondary cellular events. Caspase-dependent and -independent pathways are involved in neuronal apoptosis. Caspase-3 is the final effector of caspase-dependent apoptosis, whereas poly-ADP-ribose polymerase-1 (PARP-1) and apoptosis-inducing factor (AIF) are key executors of caspase-independent apoptosis. However, it remains unclear whether simultaneous inhibition of the 2 apoptosis pathways will be more beneficial for neuronal survival. Therefore, this study investigated the ability of coadministration of the PARP-1 inhibitor 3-aminobenzamide (3-AB) and caspase-3 inhibitor z-DEVD-fmk to attenuate apoptosis in a rat SCI model. ⋯ These results suggest that combination therapy is beneficial for neuronal function recovery in rats with SCI. The underlying mechanism may be associated with cosuppression of caspase-dependent and caspase-independent apoptosis pathways.