World Neurosurg
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Review Meta Analysis
Perioperative Multimodal Analgesia for Adults undergoing surgery of the Spine- Systematic Review and Meta-analysis of Three or More Modalities.
Multimodal analgesia is a strategy that can be used to improve pain management in the perioperative period for patients undergoing surgery of the spine. However, no review evidence is available on the quantitative models of multimodal analgesia within this clinical setting. We conducted a systematic review and meta-analysis to examine the effects of maximal (≥3 analgesic agents) multimodal analgesic medication for patients undergoing surgery of the spine. ⋯ Perioperative maximal multimodal analgesia consistently improved the visual analog scale scores for an adult population in the immediate postoperative period, with a moderate quality of evidence. We found a significant decrease in the hospital length of stay for patients who had received maximal multimodal analgesia with a high level of evidence and no statistical heterogeneity.
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Review Meta Analysis
Palliative surgery for drug resistant epilepsy in adult patients. A systematic review of the literature and a pooled analysis of outcomes.
Several types of palliative surgery to treat drug-resistant epilepsy (DRE) have been reported, but the evidence that is available is insufficient to help physicians redirect patients with DRE to the most appropriate kind of surgery. ⋯ Our analysis highlights the necessity of prospective studies, possibly randomized controlled trials, to compare different forms of palliative epilepsy surgery. Moreover, by identifying the outcome predictors associated with each technique, the best responder may be profiled for each procedure.
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Meta Analysis
The effectiveness of physical exercise after lumbar fusion surgery: a systematic review and meta-analysis.
The aim of the study was to review the effect of exercise interventions in patients after lumbar fusion surgery. It was sought to reveal the effect of exercise protocols on various clinical parameters. ⋯ The systematic review results demonstrated that cognitive therapy or consultation during the exercise program provides better outcomes in lumbar fusion surgery over exercise alone. Positive effects of core stabilization training on muscle strength and endurance were observed in the short term; however, this superiority was not the case in long-term studies. Meta-analysis results proved the positive effect of additional cognitive therapy to exercise on disability and kinesiophobia.
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Enhanced Recovery After Surgery (ERAS) protocols describe a standardized method of preoperative, perioperative, and postoperative care to enhance outcomes and minimize complication risks surrounding elective surgical intervention. A growing body of evidence is being generated as we learn to apply principles of ERAS standardization to neurosurgical patients. ⋯ This review synthesizes recent findings to generate evidence-based guidelines to manage neurosurgical oncology patients with standardized systems and assess ability of these systems to coordinate multidisciplinary, patient-centric care efforts. Furthermore, we highlight the potential usefulness of multimedia, app-based communication platforms to facilitate patient education, autonomy, and team communication within each of the 3 settings.
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Review Meta Analysis
The emerging relevance of H3K27 trimethylation loss in meningioma: A systematic review of recurrence and overall survival with meta-analysis.
It has been proposed in the most recent 2021 World Health Organization classification of brain tumors that the loss of trimethylation at histone 3 lysine site 27 (H3K27me3) might prognosticate meningioma outcomes. However, to date, the emerging literature has remained diffuse in its stance. Thus, the aim of the present study was to determine the prognostic relevance of H3K27me3 loss in meningioma. ⋯ The contemporary metadata favor a greater incidence of meningioma recurrence based independently on H3K27me3 loss, with a statistically significant difference. It is possible that these effects are more pronounced for grade 2 meningiomas; however, more robust data and analysis are needed to augment this position.