World Neurosurg
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Review Meta Analysis
De novo versus secondary dedifferentiated chordomas: a population-based analysis and integrated individual participant data meta-analysis.
There is a lack of data about the clinicopathological and molecular characteristics of de novo versus secondary dedifferentiated chordoma (DC). This integrated study aimed to investigate the similarities and differences in clinicopathological manifestations, prognoses, and molecular profiles of these 2 subtypes. ⋯ De novo and secondary DCs were statistically comparable in terms of patient demographics, clinical manifestations, and prognoses. Gross total excision and radiotherapy were optimal treatments associated with better outcomes of DC patients.
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Review Meta Analysis
Seizure Outcome After Surgery for Refractory Epilepsy Diagnosed by 18F-FDG PET/MRI：A Systematic Review and Meta-Analysis.
When magnetic resonance imaging (MRI) fails to detect an underlying epileptogenic lesion, the odds of a good outcome after epilepsy surgery are significantly lower (20%-65% compared with 60%-90% if a lesion is detected). We investigated the possible effects of introducing hybrid 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET)/MRI into the decision algorithm for patients with lesioned and nonlesioned drug-resistant epilepsy. ⋯ Seventy-one percent of patients with refractory epilepsy and 18F-FDG PET/MRI epileptogenic lesion features had a good outcome of epilepsy after surgery. Our findings can be incorporated into routine preoperative consultations and emphasize the importance of the complete resection of the temporal lobe epileptogenic zone for 18F-FDG PET/MRI detection when safe and feasible.
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Meta Analysis
Opioid versus non-opioid analgesia for craniotomy: A systematic review and meta-analysis of randomized controlled trials.
Despite the use of intraoperative opioid analgesia, postoperative pain is often reported by patients undergoing craniotomies. Opioids also cause undesirable side effects in neurosurgical patients. Hence, the role of nonopioid analgesia has been explored for craniotomies in recent years. ⋯ There were no important differences in clinical outcomes between the groups in our review. The GRADE certainty of evidence was rated low for most outcomes. Available evidence does not suggest superiority of intraoperative nonopioid over opioid analgesia for postoperative pain in patients undergoing craniotomy. More studies are needed to firmly establish the role of nonopioid intraoperative analgesics as an alternative to opioids in this population.
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Randomized Controlled Trial Multicenter Study
COMPARISON OF TUBULAR APPROACH AND UNIPORTAL INTERLAMINAR FULL-ENDOSCOPIC APPROACH IN THE TREATMENT OF LUMBAR SPINAL STENOSIS: OUR THREE YEAR RESULTS.
To report the long-term results of patients with lumbar spinal stenosis (LSS), for whom we applied the tubular and endoscopic approaches and previously published the short-term results. ⋯ The long-term results of the patients with LSS treated with tubular and endoscopic approaches were similar and very good. Bilateral decompression with minimally invasive spinal surgery methods can be completed with less tissue damage, complications, and blood loss with the unilateral approach.
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Supratentorial hemangioblastomas are benign and highly vascularized neoplasms that appear most often in the spine and posterior cranial fossa. They can also be located in the supratentorial compartment of the brain. We conducted a systematic review of the literature to better understand the clinical insights of supratentorial hemangioblastoma in adults. ⋯ Given their rarity, the literature on supratentorial hemangioblastomas is limited and based mostly on case reports. Complete surgical resection is the first choice of treatment and is associated with a good treatment outcome.