World Neurosurg
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Review Meta Analysis Comparative Study
Comparison of Anterior Controllable Antedisplacement and Fusion Versus Laminoplasty in the Treatment of Multisegment Ossification of Cervical Posterior Longitudinal Ligament: A Meta-Analysis of Clinical.
This study aims to provide a comprehensive summary of the existing literature and conduct a systematic evaluation of the clinical outcomes associated with anterior controllable antedisplacement and fusion (ACAF) and posterior laminoplasty (LP) for the treatment of multisegment ossification of the cervical posterior longitudinal ligament (OPLL). ⋯ The findings of this study suggest that, in the treatment of multilevel cervical OPLL, ACAF yields superior outcomes compared to LP. Specifically, ACAF improves postoperative neurologic function, reduces postoperative pain, lowers intraoperative blood loss, improves postoperative cervical curvature, and decreases the incidence of C5 nerve root paralysis and postoperative axial symptoms. Nonetheless, ACAF is associated with longer operative times and a higher incidence of postoperative dysphagia, though the overall incidence of postoperative complications is similar. It is important to note that these conclusions should be interpreted cautiously due to the limited sample size and the variable quality of the included studies. Further research involving larger, high-quality studies is warranted to validate these findings.
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Review Case Reports
Combined Preoperative Endovascular Embolization and Surgical Excision for Scalp Arteriovenous Malformations: A Systematic Review and Case Illustration.
To evaluate the efficacy of the combined approach of preoperative endovascular embolization (EE) and surgical excision (SE) for scalp arteriovenous malformation (AVM) and present an illustrative case report. ⋯ The management of scalp AVMs can be challenging; therefore, focused, and accurate identification of the complexity of the vascular anatomy is required. The combined method of preoperative EE and SE showed satisfactory outcomes with low rates of complications and recurrence; thus, we recommend this approach for the management of scalp AVMs.
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The path through neurosurgery is rigorous. Many neurosurgeons may experience burnout, depression, or suicide throughout training and practice. We review the literature to help foster a culture of awareness and self-care and arm trainees with coping skills to reduce burnout and, thus, suicidality during all phases of their medical careers. ⋯ Many neurosurgeons experience burnout, leading to a lack of satisfaction and early retirement; this necessitates a discipline-wide acknowledgment of endemic burnout among neurosurgeons. Systemic changes are needed to refine the training process and prioritize physician well-being- this cannot be left to chance.
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Review Meta Analysis Comparative Study
Decompression alone versus interspinous/interlaminar device placement for degenerative lumbar pathologies: Systematic Review and Meta-Analysis.
Interspinous devices (ISDs) and interlaminar devices (ILDs) are marketed as alternatives to conventional surgery for degenerative lumbar conditions; comparisons with decompression alone are limited. The present study reviews the extant literature comparing the cost and effectiveness of ISDs/ILDs with decompression alone. ⋯ Patient-reported outcomes are similar after decompression alone and ILD/ISD; the observed differences do not reach accepted minimum clinically important difference thresholds. ISD/ILDs have higher associated costs and reoperation rates, suggesting current evidence does not support ILD/ISDs as a cost-effective alternative to decompression alone.
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Vascular neurosurgery has developed significantly in Nigeria, but its burden and challenges remain unclear. This study systematically reviewed vascular neurosurgical literature from Nigeria. ⋯ This study illustrates the epidemiological burden of neurovascular pathology (based on the available data in published literature) in Nigeria, and raises awareness amongst service providers and researchers of the attendant challenges and epochal trends seen within vascular neurosurgery in Nigeria.