Neurosurgical Review最新文献

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The delicate nature of a constructive peer review: pearls from the editorial board. 建设性同行评审的微妙本质:来自编辑委员会的珍珠。
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2024-10-23 DOI: 10.1007/s10143-024-03047-y
Keng Siang Lee, Brian T Jankowitz, Christopher Hong, Nicholas G Candy, Tak Lap Poon, Joacir Graciolli Cordeiro, Osvaldo Vilela-Filho, Daniel M Prevedello
{"title":"The delicate nature of a constructive peer review: pearls from the editorial board.","authors":"Keng Siang Lee, Brian T Jankowitz, Christopher Hong, Nicholas G Candy, Tak Lap Poon, Joacir Graciolli Cordeiro, Osvaldo Vilela-Filho, Daniel M Prevedello","doi":"10.1007/s10143-024-03047-y","DOIUrl":"https://doi.org/10.1007/s10143-024-03047-y","url":null,"abstract":"<p><p>Peer review stands as a cornerstone of academic publishing, especially in the era of evidence-based neurosurgery - the scientific literature relies on proficient peer reviewers. Providing a constructive peer review is an art and learned skill that requires knowledge of study design and expertise in the neurosurgical subspeciality. Peer reviewers guard against arbitrary decision-making and are essential in ensuring that published manuscripts are of the highest quality. However, there remains a scarcity in the formal training relating to the peer review process. The objective of this article is therefore to shed light on this process through the lens of the Editorial Board. We encourage our invited peer reviewers to make use of this guide when appraising potential manuscripts.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"814"},"PeriodicalIF":2.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142504836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dural arteriovenous fistulas at the craniocervical junction: a systematic review and meta-analysis. 颅颈交界处的硬脑膜动静脉瘘:系统回顾和荟萃分析。
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2024-10-23 DOI: 10.1007/s10143-024-03018-3
Jumanah Qedair, Kiran Sankarappan, Mohammad Mirahmadi Eraghi, Zachary C Gersey, Prateek Agarwal, Sharath Kumar Anand, Paolo Palmisciano, Matthew Blackwell, Seyed Farzad Maroufi, Salah G Aoun, Tarek Y El Ahmadieh, Aaron A Cohen-Gadol, Othman Bin-Alamer
{"title":"Dural arteriovenous fistulas at the craniocervical junction: a systematic review and meta-analysis.","authors":"Jumanah Qedair, Kiran Sankarappan, Mohammad Mirahmadi Eraghi, Zachary C Gersey, Prateek Agarwal, Sharath Kumar Anand, Paolo Palmisciano, Matthew Blackwell, Seyed Farzad Maroufi, Salah G Aoun, Tarek Y El Ahmadieh, Aaron A Cohen-Gadol, Othman Bin-Alamer","doi":"10.1007/s10143-024-03018-3","DOIUrl":"10.1007/s10143-024-03018-3","url":null,"abstract":"<p><strong>Background: </strong>The management for craniocervical junction dural arteriovenous fistulas (CCJ-DAVFs) remains controversial and clinically challenging. We systemically summarized the clinical and angiographic outcomes of microsurgery, embolization, and conservative management.</p><p><strong>Methods: </strong>Relevant articles were retrieved from PubMed, Scopus, Web of Science, and Cochrane, following PRISMA guidelines. A systematic review and meta-analysis were conducted on the clinical characteristics, management approaches, and clinical and angiographic outcomes.</p><p><strong>Results: </strong>We included 13 articles (166 patients). The weighted mean age was 58.9 years (95%CI: 53.2-64.5), 58.8 years (95%CI: 48.4-69.2), and 63.8 years (95%CI: 60.1-67.5), in microsurgery, embolization, and conservative groups respectively, with an overall male sex predominance (microsurgery [n = 51/77, 66.2%], embolization [n = 44/56, 78.6%], and conservative management [n = 6/8, 75.0%]). Patients were managed with microsurgery (n = 80/172, 46.5%), embolization (n = 79/172, 45.9%), and conservative treatment (n = 13/172, 7.6%). Foramen magnum was the most common location (microsurgery [n = 34/77, 44.2%], embolization [n = 31/56, 55.4%], and conservative treatment [n = 3/8, 37.5%]). Vertebral artery was the primary feeder (microsurgery [n = 58/84, 69.1%], embolization [n = 41/86, 47.6%], and conservative treatment [n = 4/7, 57.1%]). Complete fistula obliteration rates were 74.1% (95%CI:52.3-88.2%) in the microsurgery group and 54.9% (95%CI:30.7-77.0%) in the embolization group. Complications rates were 16.2% (95%CI:6.7-34.5%) in the embolization group, 11.6% (95%CI:3.8-30.4%) in the microsurgery group, and 7.7% (95%CI:1.1-39.1%) in the conservative group. Different rates of good clinical outcomes were observed [microsurgery: 66.4% (95%CI:48.1-80.8%), embolization: 51.9% (95%CI:30.8-72.4%), and conservative: 11.6% (95%CI:4.4-27.4%)].</p><p><strong>Conclusions: </strong>In patients with CCJ-DAVFs, each management approach has its own merits based on the fistula and patient characteristics.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"812"},"PeriodicalIF":2.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142504821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pipeline Embolization device for the treatment of unruptured intracranial saccular aneurysms: a systematic review and meta-analysis of long-term outcomes. 用于治疗未破裂颅内囊状动脉瘤的管道栓塞装置:长期疗效的系统回顾和荟萃分析。
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2024-10-23 DOI: 10.1007/s10143-024-03040-5
Jorge Rios-Zermeno, Abdul Karim Ghaith, Carlos Perez-Vega, Elena Greco, Loizos Michaelides, Victor G El Hajj, Omar R Ortega-Ruiz, Jeyan S Kumar, Sukhwinder J S Sandhu, Rabih G Tawk
{"title":"Pipeline Embolization device for the treatment of unruptured intracranial saccular aneurysms: a systematic review and meta-analysis of long-term outcomes.","authors":"Jorge Rios-Zermeno, Abdul Karim Ghaith, Carlos Perez-Vega, Elena Greco, Loizos Michaelides, Victor G El Hajj, Omar R Ortega-Ruiz, Jeyan S Kumar, Sukhwinder J S Sandhu, Rabih G Tawk","doi":"10.1007/s10143-024-03040-5","DOIUrl":"10.1007/s10143-024-03040-5","url":null,"abstract":"<p><strong>Introduction: </strong>The pipeline embolization device (PED) is commonly used for intracranial aneurysm treatment. While its effectiveness for certain types of aneurysms is well-established, its efficacy for saccular aneurysms remains controversial. We aimed to assess the long-term outcomes of PED treatment for unruptured intracranial saccular aneurysms.</p><p><strong>Methods: </strong>Systematic review and meta-analysis were conducted following PRISMA guidelines. Studies with at least one year of follow-up after PED treatment for saccular aneurysms were included. The primary endpoint was angiographic aneurysm occlusion at long-term follow-up (≥ 12 months), and the secondary outcome was long-term complications. We conducted a meta-regression analysis to explore potential sources of heterogeneity across studies.</p><p><strong>Results: </strong>Eleven studies of 797 patients with 963 aneurysms were included. Long-term angiographic occlusion rate was 85% (95% CI, 77-91%; p < 0.01), symptomatic ischemic stroke rate was 1% (95% CI, 0-3%; p < 0.01), rupture rate was 1% (95% CI, 0-2%; p = 0.02), and intracranial hemorrhage (ICH) rate was 0.2% (95% CI, 0-1%; p = 0.11). Meta-regression analysis revealed a non-significant decreasing trend per year for aneurysmal occlusion, ischemic stroke rate, delayed aneurysmal rupture, and ICH.</p><p><strong>Conclusion: </strong>PED demonstrates high long-term occlusion and low complication rates, suggesting it is a safe and effective treatment option for saccular aneurysms. Additionally, newer devices exhibit reduced thrombogenic profiles and safety with decreasing trends in ICH, ischemic stroke, and delayed aneurysmal rupture.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"813"},"PeriodicalIF":2.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142504832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Quality indicators in cranial neurosurgery: current insights and critical evaluation - a systematic review. 颅神经外科的质量指标:当前见解和关键评估--系统综述。
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2024-10-23 DOI: 10.1007/s10143-024-03066-9
Stephanie Schipmann, Michael Schwake, Terje Sundstrøm, Markus Holling, Walter Stummer
{"title":"Quality indicators in cranial neurosurgery: current insights and critical evaluation - a systematic review.","authors":"Stephanie Schipmann, Michael Schwake, Terje Sundstrøm, Markus Holling, Walter Stummer","doi":"10.1007/s10143-024-03066-9","DOIUrl":"10.1007/s10143-024-03066-9","url":null,"abstract":"<p><p>In recent decades, there has been increasing interest in measuring the quality of care across all medical fields, including neurosurgery. This interest aims not only to optimize care but also to reduce healthcare costs. For this purpose, different quality indicators (QIs) have been developed. We performed a systematic review according to the PRISMA guidelines aiming at identifying studies that critically evaluate QIs applied in cranial neurosurgery. A total of 34 studies, suggesting 22 indicators, were identified. The most discussed indicator was the 30-day readmission rate, followed by the 30-day reoperation rate. The majority of QIs are influenced by baseline and underlying patient characteristics, reflecting the severity of the patient`s underlying disease, rather than adherence to best available evidence of treatment. Therefore, it is crucial to implement adequate risk adjustment strategies when applying QIs to compensate for differences in patient complexity and to ensure that departments that are treating high-risk patients do not have worse results. The review revealed several limitations of the currently used quality indicators. Most suggested indicators are attractive from a payer point of view, easy to measure and therefore convenient for reimbursement purposes. However, from a clinician's point of view, most indicators were considered poor performance markers as they do not correlate with meaningful outcome and do not reflect treatment quality. In addition, there is a lack of disease- and neurosurgery specific indicators. This highlights the need for clinicians to actively participate in developing more clinically relevant QIs tailored to neurosurgical practice.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"815"},"PeriodicalIF":2.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142504833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pregnancy and lactation associated osteoporotic vertebral fracture: the neurosurgical perspective through a multicentric study. 与妊娠和哺乳相关的骨质疏松性脊椎骨折:一项多中心研究的神经外科视角。
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2024-10-22 DOI: 10.1007/s10143-024-03056-x
Teresa Somma, Ciro Mastantuoni, Rossella Rispoli, Ilaria Bove, Andrea Bocchino, Antonio Stefano Salcuni, Lorenza Driul, Felice Esposito, Paolo Cappabianca, Enrico Tessitore, Barbara Cappelletto
{"title":"Pregnancy and lactation associated osteoporotic vertebral fracture: the neurosurgical perspective through a multicentric study.","authors":"Teresa Somma, Ciro Mastantuoni, Rossella Rispoli, Ilaria Bove, Andrea Bocchino, Antonio Stefano Salcuni, Lorenza Driul, Felice Esposito, Paolo Cappabianca, Enrico Tessitore, Barbara Cappelletto","doi":"10.1007/s10143-024-03056-x","DOIUrl":"https://doi.org/10.1007/s10143-024-03056-x","url":null,"abstract":"<p><p>Pregnancy and lactation-associated osteoporosis is a rare form of osteoporosis occurring during late pregnancy and early lactation, featuring fragility fractures, primarily involving the vertebral bodies and leading to back pain. Its management involves osteoporosis treatment, complicated by potential drug-related dangerous effects on the fetus. Nevertheless, many controversies remain regarding diagnosis, prognosis, and treatment options. Herein, we propose a multicentric case series to provide a comprehensive neurosurgical, gynecological, and endocrinological perspective on the management of pregnancy and lactation-associated osteoporotic vertebral fractures. A multicenter retrospective study was conducted at the Neurosurgical Department of Università degli Studi di Napoli Federico II, the Neurosurgical Unit of Hopitaux Universitaires de Genève, and the Spine and Spinal Cord Surgery Unit of the University Hospital of Udine, collecting data from January 2014 to December 2022. The study has been approved by the ethical committee of each hospital. N = 11 patients with an overall number of 31 fractures were eligible, with a mean age of 36. N = 5 (16%) fractures in 4 patients (36%) developed during pregnancy, and N = 26 (84%) fractures in 7 (64%) patients occurred during lactation. The mean number of fractures per patient was 2,81. In 10 (90%) patients, fractures occurred at the first pregnancy, and 5 (45%) patients had uneventful subsequent pregnancies. The mean clinical signs and symptoms were back pain (92%), followed by loss of height (75%) and kyphosis (4 patients, 35%). One (9,09%) patient underwent in vitro fertilization (IVF), and one patient (9,09%) was receiving hormonal therapy (ethinylestradiol/drosiprenone). 10 out of 11 (90%) patients were treated conservatively, and 6 of them (60%) were managed with an orthosis. One (9,1%) patient underwent surgery for 5-level kyphoplasty. The mean average reduction of pain after one year of follow-up was 6,7 on the visual analogue scale (p-value 0,04). Pregnancy-related osteoporotic vertebral fractures are an emerging issue in developing countries, for which a conservative strategy ensures the best outcomes. The main goal is to improve bone mineral density through calcium and vitamin D supplementation and bone-active drugs as bisphosphonates or teriparatide. Surgery is warranted only in cases of a risk of severe deterioration of neurological functions.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"811"},"PeriodicalIF":2.5,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Temporary Pause on letters to the editor submissions. 暂时停止向编辑投稿。
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2024-10-22 DOI: 10.1007/s10143-024-03045-0
Daniel M Prevedello
{"title":"A Temporary Pause on letters to the editor submissions.","authors":"Daniel M Prevedello","doi":"10.1007/s10143-024-03045-0","DOIUrl":"https://doi.org/10.1007/s10143-024-03045-0","url":null,"abstract":"","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"810"},"PeriodicalIF":2.5,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predictive value of the systemic immune-inflammation index for periprocedural complications in flow diverter treatment for patients with intracranial aneurysms. 全身免疫炎症指数对颅内动脉瘤患者血流分流治疗围手术期并发症的预测价值。
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2024-10-22 DOI: 10.1007/s10143-024-03053-0
Jiwan Huang, Yaxian Huang, Xin Feng, Chi Huang, Mengshi Huang, Zhuohua Wen, Anqi Xu, Runze Ge, Hao Yuan, Hongyu Shi, Gengwu Ma, Can Li, Jiancheng Lin, Ruizhe Yi, Yuqi Hu, Yuheng Jin, Shuyin Liang, Yiming Bi, Shixing Su, Xin Zhang, Xifeng Li, Chuanzhi Duan
{"title":"Predictive value of the systemic immune-inflammation index for periprocedural complications in flow diverter treatment for patients with intracranial aneurysms.","authors":"Jiwan Huang, Yaxian Huang, Xin Feng, Chi Huang, Mengshi Huang, Zhuohua Wen, Anqi Xu, Runze Ge, Hao Yuan, Hongyu Shi, Gengwu Ma, Can Li, Jiancheng Lin, Ruizhe Yi, Yuqi Hu, Yuheng Jin, Shuyin Liang, Yiming Bi, Shixing Su, Xin Zhang, Xifeng Li, Chuanzhi Duan","doi":"10.1007/s10143-024-03053-0","DOIUrl":"10.1007/s10143-024-03053-0","url":null,"abstract":"<p><p>Flow-diverter devices (FDs) are effective in treating intracranial aneurysms (IAs) but carry substantial periprocedural risks, particularly ischemic complications. This study aimed to determine if elevated Systemic Immune-Inflammation Index (SII) can independently predict these risks and assess the impact of age and dual antiplatelet therapy on this association. We conducted a retrospective analysis of patients treated with FDs between February 2016 and August 2023, using blood samples taken within six days before surgery to calculate SII. Logistic regression and decision tree analyses assessed the link between SII and periprocedural complications, with subgroups exploring influencing factors. Multivariable analysis identified high SII as an independent predictor of periprocedural complications (OR = 5.306, 95% CI: 1.367-18.455; P = 0.009). The decision tree model confirmed SII > 0.437 as a critical threshold. Subgroup analysis showed a pronounced association of SII with periprocedural complications in patients ≥ 65 years (OR = 36.979, 95% CI: 2.103-650.134; P = 0.014) and in those on clopidogrel plus aspirin therapy (OR = 16.921, 95% CI: 2.733-104.746; P = 0.002). An elevated Systemic Immune-Inflammation Index (SII) > 0.437 significantly correlates with increased periprocedural complications (6.5% vs. 1.8%, P = 0.017). Although not statistically significant, higher SII is associated with a greater rate of ischemic events (3.9% vs. 0.9%). Elevated preoperative SII independently predicts periprocedural complications, particularly ischemic events, in patients undergoing FDs treatment for intracranial aneurysms. This association is particularly pronounced in older patients (> 65 years) and those receiving dual therapy with clopidogrel plus aspirin. Trial Registration: ClinicalTrials.gov (NCT06446778). Registered on May 22, 2024.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"809"},"PeriodicalIF":2.5,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
BMI and deep brain stimulation: A comprehensive review and future directions with AI integration. BMI 和深部脑刺激:全面回顾与人工智能整合的未来方向。
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2024-10-21 DOI: 10.1007/s10143-024-03041-4
Hira Shaheen
{"title":"BMI and deep brain stimulation: A comprehensive review and future directions with AI integration.","authors":"Hira Shaheen","doi":"10.1007/s10143-024-03041-4","DOIUrl":"10.1007/s10143-024-03041-4","url":null,"abstract":"<p><p>Deep brain stimulation (DBS) has revolutionized the treatment of movement disorders, including Parkinson's disease (PD), essential tremors, dystonia, and treatment-refractory obsessive-compulsive disorder (OCD). This systematic review and meta-analysis aimed to assess the impact of DBS on Body Mass Index (BMI). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, data from 49 studies were reviewed, with 46 studies specifically focusing on BMI and DBS. These studies involved 1,478 participants, predominantly PD patients, with an average age of 58.82 years. The primary DBS implantation site was the subthalamic nucleus (STN). Over six months, the mean BMI increased from 25.69 to 27.41, despite a reduction in daily energy intake from 1992 to 1873 kJ. While the findings suggest a correlation between DBS and weight gain, the study has limitations. The sample largely comprised PD patients (91%), preventing analysis of other subtypes. Additionally, most studies focused on the STN, limiting comparisons with other targets like the globus pallidus internus (GPi). Inconsistencies in assessing daily energy intake and food consumption further complicate the results. Integrating artificial intelligence (AI) in future research could address these gaps. For example, machine learning algorithms, such as those used by Oliveira et al., can predict post-DBS weight changes based on pre-surgical BMI and demographic factors. Similarly, AI-driven models like CLOVER-DBS can optimize DBS settings for improved motor control in PD patients. In conclusion, DBS affects BMI, and AI has the potential to enhance the precision of future studies.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"808"},"PeriodicalIF":2.5,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Perioperative management of antithrombotic therapy in elderly patients undergoing lumbar discectomy: a retrospective study on 163 patients. 对接受腰椎间盘切除术的老年患者进行围手术期抗血栓治疗的管理:一项针对 163 名患者的回顾性研究。
IF 4.6 3区 医学
Neurosurgical Review Pub Date : 2024-10-21 DOI: 10.1007/s10143-024-03059-8
Giuseppe Corazzelli, Sergio Corvino, Francesco Ricciardi, Valentina Pizzuti, Settimio Leonetti, Alessandro D'Elia, Marco Santilli, Fulvio Aloj, Gualtiero Innocenzi
{"title":"Perioperative management of antithrombotic therapy in elderly patients undergoing lumbar discectomy: a retrospective study on 163 patients.","authors":"Giuseppe Corazzelli, Sergio Corvino, Francesco Ricciardi, Valentina Pizzuti, Settimio Leonetti, Alessandro D'Elia, Marco Santilli, Fulvio Aloj, Gualtiero Innocenzi","doi":"10.1007/s10143-024-03059-8","DOIUrl":"10.1007/s10143-024-03059-8","url":null,"abstract":"<p><strong>Background context: </strong>The prevalence of lumbar disc herniation (LDH) has risen alongside the aging population, often necessitating neurosurgical intervention. However, managing antithrombotic medications in elderly patients with a history of major cardiovascular events (MACE) presents challenges, as treatment may require modification or cessation. This study aims to compare surgical outcomes among elderly patients receiving antithrombotic drugs and assess their impact and potential complications. The findings aim to inform the management of elderly patients with cardiovascular and spinal conditions undergoing neurosurgery.</p><p><strong>Methods: </strong>This retrospective, observational study was conducted at a single center. A total of 163 patients aged 60 or above who underwent lumbar discectomy for LDH were included. Patients were categorized into three groups based on their antithrombotic drug management: Group A (46 patients) replaced antiplatelet agents with low-dose aspirin for secondary prevention, Group B (54 patients) discontinued antiplatelet agents for primary prevention one week preoperatively and replaced them with LMWH, and Group C (63 patients) did not receive antithrombotic medication. Intraoperative blood loss, surgical time, and postoperative hospitalization were analyzed across all three groups. Continuous variables were compared between groups using the two-tailed Mann-Whitney test, with significance set at p < 0.05.</p><p><strong>Results: </strong>No significant differences were found in intraoperative blood loss or surgical time among groups A, B, and C. Similarly, no significant differences were observed between groups B and C across all analyzed variables. No early or delayed hemorrhagic complications occurred perioperatively or during the 3-month postoperative follow-up period.</p><p><strong>Conclusions: </strong>The study suggests that elective discectomy surgery in patients receiving anticoagulant and antiplatelet therapies may proceed without early complications and can be safely continued perioperatively. These findings have implications for the management of elderly patients requiring neurosurgical intervention in the context of cardiovascular comorbidities.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"807"},"PeriodicalIF":4.6,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Natural polymeric biomaterials for managing peripheral nerve injuries : a novel approach for tissue repair and reconstruction. 管理周围神经损伤的天然聚合生物材料:组织修复和重建的新方法。
IF 2.5 3区 医学
Neurosurgical Review Pub Date : 2024-10-19 DOI: 10.1007/s10143-024-03025-4
Lokesh Prabakaran, Sathyaraj Weslen Vedakumari, Yovan Raja Pravin
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