World Neurosurg
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In recent years, unilateral biportal endoscopic spinal surgery has been used for the treatment of lumbar spinal stenosis with good results. Some investigators counted the total incidence of complications in unilateral biportal endoscopic surgery for lumbar spinal stenosis, but none have analyzed the incidence of specific complications. The present study further counted the incidence of specific complications and gave the possible causes of the complications. ⋯ The incidence of total complications of unilateral biportal endoscopic surgery for lumbar spinal stenosis was 8.1%, dural tear remained a major complication with an incidence of 4.5%, incomplete decompression was 2.0%, transient palsy was 2.6%, and, unexpectedly, symptomatic postoperative spinal epidural hematoma was only 1.1%.
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Meta Analysis
Meta-analysis of Simultaneous versus Staged Decompression of Stenotic Regions in Patients with Tandem Spinal Stenosis.
Tandem spinal stenosis (TSS) refers to simultaneous spinal canal stenosis of noncontiguous regions. There is no consensus in the surgical strategies for patients with symptomatic TSS because of the confusing clinical manifestations. This meta-analysis aimed to compare the outcomes of 1-stage and 2-stage decompression of all stenotic regions (cervical and lumbar/thoracic segments) in patients with TSS. ⋯ For patients with cervical and lumbar TSS, 2-stage decompression showed slight advantages in clinical outcome without exposing patients to unnecessary surgical risks. For patients with cervical and thoracic TSS, 1-stage decompression showed comparable clinical outcome, although with better operative parameters and lower complication rate than in simultaneous decompression.
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Meta Analysis
Bisphosphonates alleviate bone loss in people with acute spinal cord injury：a systematic review and meta-analysis.
Bone loss is not to be underestimated in people with acute spinal cord injury (SCI). Bisphosphonates can inhibit the bone resorption of osteoclast. To study whether the early application of bisphosphonates can alleviate bone loss after acute SCI, we included 7 randomized controlled trials for meta-analysis. ⋯ Bisphosphonates can effectively alleviate the bone loss of the lumbar spine, total hip, and femoral neck in patients with acute SCI, and early application is advocated.
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Phantom limb pain (PLP) is a common type of chronic pain that occurs after limb amputation. Many treatment approaches are available; however, the treatment of PLP is still a challenge. This study aimed to quantify and rank the efficacy of interventions for phantom limb pain. ⋯ Our results suggest that MT is the most optimal treatment for PLP, and a combination of therapies would enhance the therapeutic effect.
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Meta Analysis
Outcomes after endovascular treatment of direct carotid cavernous fistulas: Systematic review and meta-analysis.
Direct carotid cavernous fistulas (dCCF) involve pathologic shunting from the internal carotid artery into the cavernous sinus. We systematically reviewed the methods and outcomes of endovascular therapy for dCCF. ⋯ Endovascular therapy for dCCF is associated with high occlusion and low complication rates. Recurrence is not uncommon, highlighting the need for close follow-up.