World Neurosurg
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Review Meta Analysis
Incidence of Subsidence of 7 intervertebral Devices in Anterior Cervical Discectomy and Fusion: A Network Meta-analysis.
Subsidence is an incapacitating complication in anterior cervical discectomy and fusion (ACDF). However, the debate over which of the intervertebral devices is associated with lower incidence of subsidence remains to be settled. ⋯ CP and IP resulted in a lower rate of subsidence than cage alone or ICAG. Zero-P and ROI-C cages led to similar subsidence rates with plate. All types of intervertebral device can be applied to both single-level and multilevel ACDF with comparable subsidence rate.
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Review Meta Analysis
Risk Factors for Wound-Related Complications Following Surgery for Primary and Metastatic Spine Tumors: A Systematic Review and Meta-Analysis.
We systematically reviewed the literature to compare risk factors for postoperative complications at the surgical wound site in primary and metastatic tumor operations. ⋯ Risk factors for wound complications after primary tumor operations were related to tumor histology and the spinal location of the operation. Risk factors for metastatic tumors may be related to several systemic preoperative treatments and baseline comorbidities. Random-effects meta-analysis showed the limited generalizability of these findings because of the small heterogenous primary literature.
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Review Meta Analysis
The role of platelet transfusions after intracranial hemorrhage in patients on antiplatelet agents: a systematic review and meta-analysis.
The evidence suggests that antiplatelet agents (APA) slightly increase the risk of death and disease progression in patients with traumatic brain injury or spontaneous intracranial hemorrhage (ICH). There is little evidence that APA reversal with platelet (PLT) transfusion may improve the outcome. In this systematic review and meta-analysis, our goal was to evaluate the differences in mortality, severe disability, and hematoma expansion related to PLT transfusion. ⋯ We observed a significant difference between the 2 groups only for hematoma expansion: risk difference was -0.10 (10%; 95% confidence interval, -0.14 to -0.05; P < 0.0001; I2 = 0.90) in favor of PLT transfusion. Performing subgroups analyses according to the type of bleeding mechanism, we observed the same results. The use of PLT in patients on APA affected by ICH seemed to have no clear beneficial effect for the outcomes evaluated; conversely, PLT seemed to slightly increase the odds for adverse events of thromboembolic origin, even although not significantly.