Neurosurgical Review最新文献

{"title":"Prognostic value of computed tomography and magnetic resonance imaging findings in acute traumatic brain injury in prediction of poor neurological outcome and mortality: a systematic review and meta-analysis.","authors":"Arvin Naeimi, Sepehr Aghajanian, Kyana Jafarabady, Reza Aletaha, Seyed Farzad Maroufi, MirHojjat Khorasanizadeh, Martina Stippler","doi":"10.1007/s10143-024-03071-y","DOIUrl":"10.1007/s10143-024-03071-y","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) is a major cause of morbidity and mortality, impacting healthcare systems and economies. Early identification of poor outcomes is crucial for effective treatment. This systematic review assesses the prognostic value of computed tomography (CT) and magnetic resonance imaging (MRI) findings in predicting poor neurological outcomes and mortality in the acute phase of TBI. A comprehensive search of Scopus, MEDLINE, and Web of science databases was performed to identify studies examining CT and MR-based imaging findings and their association with poor outcomes as assessed by Glasgow outcome score as well as mortality within the early acute phase of TBI following injury/admission. Qualitative evaluation of included studies revealed several imaging sequences that modify the outcome of the patients, including extra-axial and intra-axial hemorrhage, swirl sign, contrast extravasation, midline shift, closed and open cranial cisterns, signs of edema, presence of cranial fractures, intracranial hemorrhage, cerebral microbleeds, diffuse axonal injury, apparent diffusion coefficient and fractional anisotropy in diffusion tensor imaging, as well as, concentrations of brain metabolites(N-acetyl aspartate, Creatinine, Choline, Myo-inositol, glutamate, and glutamine) in magnetic resonance spectroscopy. Among these markers, subarachnoid hemorrhage (SAH) and subdural hematoma (SDH) emerged as the most predictive of poor outcomes based on meta-analysis findings. SAH was significantly associated with an increased risk of mortality (OR: 3.35, 95% CI: 2.41-4.65, I²=51.3%) and poor outcomes (OR: 2.69, 95% CI: 2.44-2.96, I²=0%). Similarly, SDH correlated with higher mortality risk (OR: 2.44, 95% CI: 2.14-2.78, I²=0%) and worse outcomes (OR: 2.00, 95% CI: 1.12-3.59, I²=60.9%). In contrast, epidural hematoma (EDH) was linked to better outcomes (OR: 0.60, 95% CI: 0.52-0.68, I²=0%) but not significantly associated with mortality (OR: 0.38, 95% CI: 0.09-1.65, I²=73.7%). The results of this systematic review and meta-analysis provide an overview of clinically feasible imaging markers of prognostic value and may inform clinical decision-making in the future.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"837"},"PeriodicalIF":2.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584039","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}

{"title":"MR-proANP levels in Acute ischemic stroke and clinical outcomes: a systematic review and meta-analysis.","authors":"Basel Musmar, Hamza Adel Salim, Brian Mac Grory, Fares Musmar, Samantha Spellicy, Jihad Abdelgadir, Nimer Adeeb, David Hasan","doi":"10.1007/s10143-024-03073-w","DOIUrl":"https://doi.org/10.1007/s10143-024-03073-w","url":null,"abstract":"<p><p>In patients with acute ischemic stroke, midregional proatrial natriuretic peptide (MR-proANP) has shown promise in preliminary studies for risk stratification. The objective of this study is to evaluate the prognostic utility of MR-proANP in AIS, focusing on its ability to predict 90-day functional outcomes, mortality rates, and the presence of atrial fibrillation (Afib). A comprehensive literature search was conducted using PubMed, Web of Science, and Scopus, following PRISMA guidelines. The search strategy employed a combination of keywords and index terms including \"Acute Ischemic Stroke,\" \"AIS,\" \"Cerebral Infarction,\" \"Atrial Fibrillation,\" \"AFib,\" \"stroke,\" \"MR-proANP,\" \"Mid-regional pro-atrial natriuretic peptide,\" and \"proatrial natriuretic peptide.\" Inclusion criteria encompassed any study focusing on MR-proANP and ischemic stroke, published up to October 15, 2023. Primary end points were newly diagnosed Afib, 90-day Modified Rankin Scale (mRS) score, and 90-day mortality. Studies were described in narrative and tabular form. Risk of bias was assessed using the ROBINS-I tool. Pooled estimates for our key end points were generated using a random effects model where appropriate. MR-proANP levels were significantly elevated in newly diagnosed Afib patients compared to no Afib patients (mean difference (MD): 134.4 pmol/l; 95% confidence interval (CI): 119.45 to 149.35, P < 0.0001). Unfavorable functional outcomes, as measured by mRS scores of ≥ 3 at 90 days, were associated with higher levels of MR-proANP (MD: 93.87 pmol/; 95% CI: 76.66 to 111.09, P < 0.0001). Elevated MR-proANP levels were also strongly correlated with increased 90-day mortality rates (MD: 164.43 pmol/; CI: 95.94 to 232.92, P < 0.0001). MR-proANP was significantly associated with functional outcomes, 90-day mortality, and the newly diagnosed AF. The limited number of studies included calls for further large-scale research to confirm these findings and explore the potential for expedited diagnostic procedures and targeted interventions like anticoagulant therapy.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"835"},"PeriodicalIF":2.5,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576679","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}

{"title":"Pre-treatment DTI markers: predicting clinical outcomes in microvascular decompression for classic trigeminal neuralgia - a systematic review.","authors":"Giuseppe Pio Cipollina, Roberta Costanzo, Benedetta Maria Campisi, Gianluca Scalia, Lara Brunasso, Lapo Bonosi, Domenico Gerardo Iacopino, Rosario Maugeri","doi":"10.1007/s10143-024-03062-z","DOIUrl":"10.1007/s10143-024-03062-z","url":null,"abstract":"<p><strong>Background and purpose: </strong>Trigeminal neuralgia (TN) is a severe chronic pain condition, typically affecting patients over 50-year-old, caused by the compression of the nerve at the root entry zone (REZ) by blood vessels. While the diagnosis is clinical, advanced imaging like diffusion tensor imaging (DTI) is crucial to identify underlying causes and assessing nerve damage. DTI may help develop neuroimaging markers to improve understanding of TN and predict surgical outcomes. The goal of the present systematic review is to evaluate the effectiveness of DTI and tractography in order to better assess treatment planning and outcome prediction through the analysis of trigeminal nerve alterations.</p><p><strong>Methods: </strong>The authors conducted a systematic review and meta-analysis of the literature to compare radiological parameters identified in pre- and post-operative MRI with DTI sequences, including fractional anisotropy (FA), quantity of anisotropy (QA), radial diffusivity (RD), and to correlate these findings with post-operative clinical outcomes. A comprehensive search of the PubMed and Scopus databases was carried out for studies published between April 2010 and January 2024.</p><p><strong>Results: </strong>This review included 11 studies and 603 patients. Of the 363 patients with trigeminal neuralgia (TN), 193 underwent microvascular decompression (MVD), with 72.5% showing clinical improvement and 27.5% not improving, possibly due to chronic nerve damage. Four studies assessed radiological parameters before and after MVD, while two focused only on post-MVD data. The mean fractional anisotropy (FA) in affected nerves increased from 0.328 before MVD to 0.382 afterward. Five studies did not report postoperative outcomes, just comparing radiological parameters in TN patients versus healthy controls.</p><p><strong>Conclusions: </strong>Recent studies show that MRI-DTI parameters, including FA, RD, and QA, are useful for diagnosing trigeminal neuralgia and predicting treatment outcomes. Lower FA and higher RD values indicate better results after surgery. More research is mandatory to guide treatment decisions and enhance patients' care.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"833"},"PeriodicalIF":2.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567919","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}

{"title":"Subaxial cervical foraminal chondromas: case-based discussion on surgical management.","authors":"Alberto Vandenbulcke, Andrea Sanjurjo, Anne-Laure Rougemont, Sana Boudabbous, Rodolfo Maduri","doi":"10.1007/s10143-024-03065-w","DOIUrl":"10.1007/s10143-024-03065-w","url":null,"abstract":"<p><p>Cervical foraminal chondromas are benign lesions that may require surgical resection when symptomatic due to radicular and/or spinal cord compression. The aim of surgery is to achieve gross tumor removal while preserving neurological function and spine stability. The authors describe a case of subaxial foraminal chondroma with a systematic review of the literature on patients with cervical chondromas. In the reported case, the authors used a retrojugular approach to remove a C6-C7 right chondroma without the need for spinal stabilization. Literature review identified a total of 11 patients who underwent surgery for subaxial foraminal chondroma. The mean age at diagnosis is 33.6 years (range: 10-73). Most patients report neurological symptoms at the time of diagnosis. The most frequently involved vertebral level is C4-C5 (54.6%, 6/11). Preoperative foraminal enlargement is present in 63.6% (7/11) of patients. Surgical resection is performed via an anterior approach in 18.2% (2/11) of patients, with vertebral body resection and concomitant cervical instrumentation. The anterolateral approach is selected in 27.2% (3/11) of patients, and the posterior approach in 54.6% (6/11) of patients, with only one patient requiring both anterior and posterior instrumentation. The choice of surgical access for subaxial foraminal chondroma can be challenging due to the anatomical location of the tumor in relation to the cervical nerve roots and spinal cord. Accurate approach selection is key to achieving complete tumor removal while preserving cervical spine stability.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"834"},"PeriodicalIF":2.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11532321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frame-based stereotactic biopsies of brainstem lesions - Monocentric comparison of the transfrontal and the suboccipital-transcerebellar approach over a 16-year period.","authors":"Manuel Kaes, Jan-Oliver Neumann, Christopher Beynon, Paul V Naser, Karl Kiening, Sandro M Krieg, Martin Jakobs","doi":"10.1007/s10143-024-03075-8","DOIUrl":"10.1007/s10143-024-03075-8","url":null,"abstract":"<p><p>Both the transfrontal and the suboccipital-transcerebellar approach are frequently used trajectories for frame-based stereotactic biopsies of brainstem lesions. Nevertheless, it remains unclear which approach is more favorable in terms of complications, diagnostic success and outcome, especially considering the location of the lesion within the brainstem. This study compared the safety and diagnostic yield of these two approaches. Furthermore, a brainstem zone model was created to answer the question, whether there is a favorable approach depending on the location of the lesion in the brainstem. A retrospective analysis of 84 consecutive cases of frame-based stereotactic biopsies for brainstem lesions via either transfrontal or suboccipital-transcerebellar approaches over a 16-year period was performed. Clinical and surgical data regarding trajectories, histopathology, complications and outcome was collected. The brainstem was divided in anatomical zones to compare the use of the two approaches depending on the location of the lesions. A total of n = 84 cases of stereotactic biopsies for brainstem lesions were performed. In 36 cases the suboccipital-transcerebellar approach was used, while in 48 cases surgery was performed via the transfrontal approach. The patient's demographic data were comparable between the two approaches. Overall diagnostic yield was 90.5% (93.8% transfrontal vs. 86.1% suboccipital, p = 0.21, Risk Difference (RD) 0.077, CI [-0.0550, 0.2090]). Complications occurred in 11 cases (total complication rate: 13.1%; 12.5% transfrontal vs. 13.9% suboccipital, p = 0.55, RD 0.014, CI [-0.1607, 0.1327]). The brainstem model showed a more frequent use of the suboccipital approach in lesions of the dorsal pons. The transfrontal approach was used more frequently in mesencephalic targets. No significant differences in terms of complications and diagnostic yield were observed, even though complications in medullary lesions appeared higher using the transfrontal approach. This study showed, that if the approaches are used for their intended target locations there are no significant differences between the transfrontal and the suboccipital-transcerebellar approach for frame-based stereotactic biopsies of brainstem lesions in terms of diagnostic yield and safety. Therefore, our data suggests that both approaches should be considered for stereotactic biopsy of brainstem lesions.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"832"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11527920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic values of combined ratios of white blood cells in glioma: a systematic review and meta-analysis.","authors":"JiaNuo Zhou, Botao Tan, Feng Gao","doi":"10.1007/s10143-024-03064-x","DOIUrl":"10.1007/s10143-024-03064-x","url":null,"abstract":"<p><p>Gliomas, the most prevalent type of neurological tumor, pose a challenging prognosis for patients. Recent studies have underscored the importance of inflammatory markers such as the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and monocyte/lymphocyte ratio (MLR) in predicting the prognosis of gliomas. We undertook a thorough meta-analysis to elucidate the role of these inflammatory markers in forecasting the prognosis of glioma patients. We extracted hazard ratios (HR) and their corresponding 95% confidence intervals (95% CI) from each study for analysis. To assess heterogeneity and identify influential studies, we conducted sensitivity analysis. Subgroup analysis was performed to investigate sources of heterogeneity, and we employed Egger's test to evaluate publication bias in the meta-analysis. Higher NLR levels were associated with shorter overall survival (HR = 1.46, 95% CI: 1.33-1.60) and progression-free survival (HR = 1.24, 95% CI: 1.04-1.48). There was no significant correlation between PLR levels and overall survival (HR = 1.01, 95% CI: 1.00-1.01) or progression-free survival (HR = 1.00, 95% CI: 0.98-1.02) in glioma patients. Elevated MLR levels were associated with decreased overall survival in glioma patients (HR = 1.78, 95% CI: 1.36-2.34). SII levels did not show any significant association with overall or progression-free survival in glioma patients (HR = 1.00, 95% CI: 0.99-1.01).In the sensitivity analysis, two studies potentially contributed to the instability. Subgroup analyses showed patient population and area were identified as potential sources of heterogeneity. Egger's test showed that there was publication bias in the relationship between NLR and PLR and overall survival (P < 0.05).All randomized controlled models, except for these, were not affected by publication bias. NLR and MLR are two reliable indicators of inflammation in the prognosis of glioma patients; PLR and SII do not have significant value in the prognosis of glioma patients.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"831"},"PeriodicalIF":2.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546535","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}

{"title":"Complication avoidance, rehabilitation, pain therapy and palliative care for patients with metastatic spine tumors: WFNS spine committee recommendations.","authors":"Mirza Pojskic, Sait Naderi, Sandeep Vaishya, Mehmet Zileli, Francesco Costa, Salman Sharif, Ziya L Gokaslan","doi":"10.1007/s10143-024-03050-3","DOIUrl":"10.1007/s10143-024-03050-3","url":null,"abstract":"<p><strong>Objective: </strong>This review aims to formulate the most current, evidence-based recommendations regarding complication avoidance, rehabilitation, pain therapy and palliative care for patients with metastatic spine tumors.</p><p><strong>Methods: </strong>A systematic literature search in PubMed and MEDLINE, and was performed from 2013 to 2023 using the search terms \"complications\" + \"spine metastases\", \"spine metastases\" + + \"rehabilitation\", \"spine metastases\" + \"pain therapy\" + \"palliative care\". Screening criteria resulted in 35, 15 and 56 studies respectively that were analyzed. Using the Delphi method and two rounds of voting at two separate international meetings, nine members of the WFNS (World Federation of Neurosurgical Societies) Spine Committee generated nine final consensus statements.</p><p><strong>Results: </strong>Preoperative assessment for complications following surgery in patients with metastatic spine tumors should include estimation of Karnofsky score, site of primary tumor, number of spinal and visceral metastasis, ASA score and preoperative Hb (Hemoglobin) value. Complication risk factors are age > 65 years, preoperative ASA score of 3 and 4 and greater operative blood loss. Pain management using WHO analgesic concept and early mobilization are needed, starting with non-opioids, weak opioids followed by strong opioids. Morphine is the first choice for moderate to severe pain whereas IV-PCA may be used for severe breakthrough pain with monitoring. Use of bisphosphonates is considered in cases of non-localized pain and not accessible radiation therapy.</p><p><strong>Conclusions: </strong>These nine final consensus statements provide current, evidence-based guidelines on complication avoidance, rehabilitation, pain therapy and palliative care for patients with spinal metastases.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"830"},"PeriodicalIF":2.5,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11525440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of age on surgical outcomes for world federation of neurosurgical societies grade I and II aneurysmal subarachnoid haemorrhage: a novel prognostic model using recursive partitioning analysis.","authors":"Motoyuki Umekawa, Gakushi Yoshikawa","doi":"10.1007/s10143-024-03067-8","DOIUrl":"10.1007/s10143-024-03067-8","url":null,"abstract":"<p><p>This study aimed to evaluate age as a prognostic factor and develop a comprehensive prognostic model for patients undergoing clipping surgery for World Federation of Neurosurgical Societies (WFNS) grade I/II aneurysmal subarachnoid haemorrhage (SAH). We retrospectively investigated 188 patients with WFNS grade I/II SAH who underwent microsurgical clipping at our institute between December 2010 and January 2020. The data of 176 patients (75 with grade I and 101 with grade II) were analysed. Data on patient demographics, aneurysm characteristics, SAH factors, surgical details, and clinical outcomes were collected. Prognostic factors were assessed using bivariate and multivariable logistic regression analyses, and recursive partitioning analysis. Favourable outcomes (mRS 0-2) were observed in 76% of patients. Age, a significant negative prognostic factor in multivariable analysis (odds ratio 0.55, 95% confidence interval 0.40-0.76, p < 0.001), was cutoff at 70 years by the receiver operating characteristic curve. Patients aged ≤ 70 years had significantly better outcomes than those aged > 70 years (84% vs. 46%, respectively; p < 0.001). Epileptic seizures were significantly associated with poor outcomes in older adults (p < 0.001). A prognostic model (favourable, intermediate, and poor) based on age and postoperative adverse events showed significantly different outcomes between age groups (p < 0.001). Age was a stronger prognostic factor than WFNS grading for patients with grade I/II SAH undergoing microsurgical clipping. For patients aged ≤ 70 years, precise microsurgeries with fewer complications were associated with favourable outcomes beyond WFNS grade. For older patients, postoperative intensive seizure management may prevent poor outcomes.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"829"},"PeriodicalIF":2.5,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of an In-Hospital postoperative imaging after uncomplicated elective posterior lumbar fixation: A case series.","authors":"Mohamed Ar AbdelFatah, Abdelrahman El Gayar, Mostafa K Ghobashy, Sameh Hefny","doi":"10.1007/s10143-024-03055-y","DOIUrl":"10.1007/s10143-024-03055-y","url":null,"abstract":"<p><strong>Purpose: </strong>Following spinal fixation, postoperative imaging is routinely performed. The value of routine postoperative imaging and its impact on the surgical decision remains uncertain, especially in degenerative cases. Moreover, routine postoperative imaging is not free and is an ionizing radiation. This study investigated the value of postoperative imaging after uneventful uncomplicated elective posterior lumbar fixation.</p><p><strong>Methods: </strong>This case series retrospectively reviewed the medical records of patients who underwent elective posterior lumbar fixation surgeries at our institution within two years. A series of 98 cases met our selection criteria. Their mean age was 51.2 years. We reviewed the decisions taken after performing the routine postoperative images. We searched for further diagnostic or imaging studies, revision surgery, or an extended hospital stay.</p><p><strong>Results: </strong>We found no particular decision was made after performing the postoperative imaging after uneventful uncomplicated elective posterior lumbar fixation surgeries. Moreover, there was no change in the hospital stay or the regular postoperative clinical management for all the included patients. No revision surgery was required based on the postoperative routine images.</p><p><strong>Conclusions: </strong>We found that routine postoperative imaging after posterior fixation of a degenerative lumbar spine is of limited value. A randomized, controlled study is helpful to confirm this finding.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"828"},"PeriodicalIF":2.5,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Woven EndoBridge device as a good alternative treatment for stent assisted coiling in intracranial bifurcation aneurysms: a systematic review and meta-analysis.","authors":"Mohammad Amin Dabbagh Ohadi, Seyyed Amir Asef, Raha Zamani, Mohammad Dashtkoohi, Basel Musmar, Ali Zomorodi, David Hasan","doi":"10.1007/s10143-024-03016-5","DOIUrl":"10.1007/s10143-024-03016-5","url":null,"abstract":"<p><strong>Objectives: </strong>The Woven EndoBridge (WEB), functioning as an intrasaccular disruption device, offers a novel option for complex aneurysms, particularly bifurcation aneurysms. In this systematic review and meta-analysis, our goal is to compare the safety and efficacy of WEB devices with stent-assisted coiling (SAC) for intracranial bifurcation aneurysms.</p><p><strong>Methods: </strong>We conducted a systematic search of PubMed, Scopus, and Embase, and Web of Science databases in September 2024 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We aimed to compare aneurysmal occlusion, procedural time, the retreatment, and complication rates as secondary objectives. The comparison between the two techniques was performed using a weighted random-effects model, and the quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) for cohort studies.</p><p><strong>Results: </strong>The authors analyzed five studies encompassing 298 and 203 patients in SAC and WEB groups, respectively. Complete (OR, 0.97; 95%CI: 0.63-1.49, I² = 0%) and adequate (OR: 0.88; 95%CI: 0.51-1.5, I² = 0%) occlusion didn't differ between two groups. The overall procedural time mean difference was 38.2 min, significantly higher in the SAC group (95%CI, 26.9-49.6, I² = 53.4%). Retreatment rates did not significantly differ between the two groups (OR: 1.34; 95%CI: 0.37-4.85, I² = 61.7%). The SAC group experienced more complications during and after the operation (OR, 2.82; 95%CI: 1.07-7.44, I² = 0%). The pooled follow-up duration was 22.1 and 13.5 months for SAC and WEB groups respectively.</p><p><strong>Conclusion: </strong>The WEB demonstrates comparable efficacy in occluding bifurcation aneurysms compared to SAC, with the added benefits of reduced procedural time and lower complication rates.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"825"},"PeriodicalIF":2.5,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522513","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}