Laminectomy and fusion vs laminoplasty for multi-level cervical myelopathy: a systematic review and meta-analysis

Abstract Objective Degenerative cervical myelopathy (DCM) is a disabling neurological condition. The underlying degenerative changes are known to be more common with age, but the impact of age on clinical aspects of DCM has never been synthesised. The objective of this study is to determine whether age is a significant predictor in three domains—clinical presentation, surgical management and post-operative outcomes of DCM. Methods a systematic review of the Medline and Embase databases (inception to 12 December 2019), registered with PROSPERO (CRD42019162077) and reported in accordance with preferred reporting items of systematic reviews and meta-analysis (PRISMA) guidelines, was conducted. The inclusion criteria were full text articles in English, evaluating the impact of age on clinical aspects of DCM. Results the initial search yielded 2,420 citations, of which 206 articles were eventually included. Age was found to be a significant predictor in a variety of measures. Within the presentation domain, older patients have a worse pre-operative functional status. Within the management domain, older patients are more likely to undergo posterior surgery, with more levels decompressed. Within the outcomes domain, older patients have a worse post-operative functional status, but a similar amount of improvement in functional status. Because of heterogenous data reporting, meta-analysis was not possible. Conclusion the current evidence demonstrates that age significantly influences the presentation, management and outcomes of DCM. Although older patients have worse health at all individual timepoints, they experience the same absolute benefit from surgery as younger patients. This finding is of particular relevance when considering the eligibility of older patients for surgery.

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Happy to Help? A systematic review and meta-analysis of the effects of performing acts of kindness on the well-being of the actor

10.31219/osf.io/ytj5s ◽

2016 ◽

Cited By ~ 1

Author(s):

Oliver Scott Curry ◽

Lee Rowland ◽

Caspar J. Van Lissa ◽

Sally Zlotowitz ◽

John McAlaney ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Well Being ◽

Future Research ◽

Subjective Well Being ◽

Community Members ◽

Multiple Control ◽

Total N ◽

Multi Level ◽

Behavioural Sciences

Do acts of kindness improve the well-being of the actor? Recent advances in the behavioural sciences have provided a number of explanations of human social, cooperative and altruistic behaviour. These theories predict that people will be ‘happy to help’ family, friends, community members, spouses, and even strangers under some conditions. Here we conduct a systematic review and meta-analysis of the experimental evidence that kindness interventions (for example, performing ‘random acts of kindness’) boost subjective well-being. Our initial search of the literature identified 489 articles; of which 24 (27 studies) met the inclusion criteria (total N=4,045). These 27 studies, some of which included multiple control conditions and dependent measures, yielded 52 effect sizes. Multi-level modelling revealed that the overall effect of kindness on the well-being of the actor is small-to-medium (δ = 0.28). The effect was not moderated by sex, age, type of participant, intervention, control condition or outcome measure. There was no indication of publication bias. We discuss the limitations of the current literature, and recommend that future research test more specific theories of kindness: taking kindness-specific individual differences into account; distinguishing between the effects of kindness to specific categories of people; and considering a wider range of proximal and distal outcomes. Such research will advance our understanding of the causes and consequences of kindness, and help practitioners to maximise the effectiveness of kindness interventions to improve well-being.

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Association of tranexamic acid with decreased blood loss in patients undergoing laminectomy and fusion with posterior instrumentation: a systematic review and meta-analysis

Journal of Neurosurgery Spine ◽

10.3171/2021.7.spine202217 ◽

2021 ◽

pp. 1-8

Author(s):

Nolan J. Brown ◽

Elliot H. Choi ◽

Julian L. Gendreau ◽

Vera Ong ◽

Alexander Himstead ◽

...

Keyword(s):

Systematic Review ◽

Blood Loss ◽

Tranexamic Acid ◽

Spine Surgery ◽

Posterior Instrumentation ◽

Meta Analysis ◽

Route Of Administration ◽

Transfusion Rate ◽

Wide Range ◽

Laminectomy And Fusion

OBJECTIVE Tranexamic acid (TXA) is an antifibrinolytic agent associated with reduced blood loss and mortality in a wide range of procedures, including spine surgery, traumatic brain injury, and craniosynostosis. Despite this wide use, the safety and efficacy of TXA in spine surgery has been considered controversial due to a relative scarcity of literature and lack of statistical power in reported studies. However, if TXA can be shown to reduce blood loss in laminectomy with fusion and posterior instrumentation, more surgeons may include it in their armamentarium. The authors aimed to conduct an up-to-date systematic review and meta-analysis of the efficacy of TXA in reducing blood loss in laminectomy and fusion with posterior instrumentation. METHODS A systematic review and meta-analysis, abiding by PRISMA guidelines, was performed by searching the databases of PubMed, Web of Science, and Cochrane. These platforms were queried for all studies reporting the use of TXA in laminectomy and fusion with posterior instrumentation. Variables retrieved included patient demographics, surgical indications, involved spinal levels, type of laminectomy performed, TXA administration dose, TXA route of administration, operative duration, blood loss, blood transfusion rate, postoperative hemoglobin level, and perioperative complications. Heterogeneity across studies was evaluated using a chi-square test, Cochran’s Q test, and I2 test performed with R statistical programming software. RESULTS A total of 7 articles were included in the qualitative study, while 6 articles featuring 411 patients underwent statistical analysis. The most common route of administration for TXA was intravenous with 15 mg/kg administered preoperatively. After the beginning of surgery, TXA administration patterns were varied among studies. Blood transfusions were increased in non-TXA cohorts compared to TXA cohorts. Patients administered TXA demonstrated a significant reduction in blood loss (mean difference −218.44 mL; 95% CI −379.34 to −57.53; p = 0.018). TXA administration was not associated with statistically significant reductions in operative durations. There were no adverse events reported in either the TXA or non-TXA patient cohorts. CONCLUSIONS TXA can significantly reduce perioperative blood loss in cervical, thoracic, and lumbar laminectomy and fusion procedures, while demonstrating a minimal complication profile.

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Systematic review and updated meta-analysis of multi-level surgery for patients with OSA

Auris Nasus Larynx ◽

10.1016/j.anl.2021.10.001 ◽

2021 ◽

Author(s):

Yan-Ye Su ◽

Pei-Wen Lin ◽

Hsin-Ching Lin ◽

Chun-Tuan Chang ◽

Chih-Yun Lin ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Multi Level

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Letter to the Editor concerning “Treating multi-level cervical disc disease with hybrid surgery compared to anterior cervical discectomy and fusion: a systematic review and meta-analysis’’ by Lu, V.M., Zhang, L., Scherman, D.B. et al. Eur Spine J (2016). doi:10.1007/s00586-016-4791-y

European Spine Journal ◽

10.1007/s00586-016-4820-x ◽

2016 ◽

Vol 26 (1) ◽

pp. 285-287

Author(s):

Yongzhao Zhao ◽

Guoxin Fan ◽

Yanjie Zhu ◽

Shisheng He

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Anterior Cervical Discectomy ◽

Cervical Disc ◽

Cervical Disc Disease ◽

Hybrid Surgery ◽

Disc Disease ◽

Cervical Discectomy ◽

Letter To The Editor ◽

Multi Level

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Reply to the Letter to the Editor of Yongzhao Zhao et al. concerning “Treating multi-level cervical disc disease with hybrid surgery compared to anterior cervical discectomy and fusion: a systematic review and meta-analysis” by Lu VM, Zhang L, Scherman DB et al. Eur Spine J (2016). doi:10.1007/s00586-015-4324-0

European Spine Journal ◽

10.1007/s00586-016-4825-5 ◽

2016 ◽

Vol 26 (1) ◽

pp. 288-288

Author(s):

Victor M. Lu ◽

Kevin Phan

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Anterior Cervical Discectomy ◽

Cervical Disc ◽

Cervical Disc Disease ◽

Hybrid Surgery ◽

Disc Disease ◽

Cervical Discectomy ◽

Letter To The Editor ◽

Multi Level

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Do Alcohol Prevention Programs Influence Adolescents’ Drinking Behaviors? A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168524 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8524

Author(s):

Mi-Kyoung Cho ◽

Yoon-Hee Cho

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Drinking Behavior ◽

Prevention Programs ◽

Alcohol Prevention ◽

Motivational Interventions ◽

Prevention Interventions ◽

Korean And English ◽

Drinking Behaviors ◽

Multi Level

This study analyzed the effects of various alcohol prevention programs on the drinking behavior of adolescents. There were seven electronic databases used for the literature search. A systematic review and meta-analysis are employed for works published in Korean and English from January 2010 to April 2021, with strict inclusion criteria yielding 12 papers in the review. The type of alcohol prevention interventions included educational and motivational interventions. Six studies had more than 500 participants each, and five studies had more than 10 participating schools. The programs did not effectively reduce the frequency of drinking or binge drinking of adolescents but significantly reduced the amount of alcohol consumed. Based on the results of this study, when planning alcohol prevention programs for adolescents, it is necessary to adopt a multi-level approach, including the engagement of parents and the community.

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