Clinical outcomes of lumbar spinal surgery in patients 80 years or older with lumbar stenosis or spondylolisthesis: a systematic review and meta-analysis

2020 ◽  
Vol 29 (9) ◽  
pp. 2129-2142
Author(s):  
Haifeng Liang ◽  
Shunyi Lu ◽  
Dongjie Jiang ◽  
Qinming Fei
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Spinal Surgery ◽  
Meta Analysis ◽  
Lumbar Stenosis ◽  
Lumbar Spinal Surgery ◽  
Lumbar Spinal

Endoscopic decompression for the treatment of lumbar spinal stenosis: an updated systematic review and meta-analysis

2021 ◽  
pp. 1-9
Author(s):  
Roberto J. Perez-Roman ◽  
Wendy Gaztanaga ◽  
Victor M. Lu ◽  
Michael Y. Wang
Keyword(s):  
Systematic Review ◽  
Back Pain ◽  
Length Of Stay ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Spinal Stenosis ◽  
Meta Analysis ◽  
Lumbar Stenosis ◽  
Lumbar Spinal ◽  
Endoscopic Methods

OBJECTIVE Lumbar stenosis treatment has evolved with the introduction of minimally invasive surgery (MIS) techniques. Endoscopic methods take the concepts applied to MIS a step further, with multiple studies showing that endoscopic techniques have outcomes that are similar to those of more traditional approaches. The aim of this study was to perform an updated meta-analysis and systematic review of studies comparing the outcomes between endoscopic (uni- and biportal) and microscopic techniques for the treatment of lumbar stenosis. METHODS Following PRISMA guidelines, a systematic search was performed using the Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Ovid Embase, and PubMed databases from their dates of inception to December 14, 2020. All identified articles were then systematically screened against the following inclusion criteria: 1) studies comparing endoscopic (either uniportal or biportal) with minimally invasive approaches, 2) patient age ≥ 18 years, and 3) diagnosis of lumbar spinal stenosis. Bias was assessed using quality assessment criteria and funnel plots. Meta-analysis using a random-effects model was used to synthesize the metadata. RESULTS From a total of 470 studies, 14 underwent full-text assessment. Of these 14 studies, 13 comparative studies were included for quantitative analysis, totaling 1406 procedures satisfying all criteria for selection. Regarding postoperative back pain, 9 studies showed that endoscopic methods resulted in significantly lower pain scores compared with MIS (mean difference [MD] −1.0, 95% CI −1.6 to −0.4, p < 0.01). The length of stay data were reported by 7 studies, with endoscopic methods associated with a significantly shorter length of stay versus the MIS technique (MD −2.1 days, 95% CI −2.7 to −1.4, p < 0.01). There was no significant difference with respect to leg visual analog scale scores, Oswestry Disability Index scores, blood loss, surgical time, and complications, and there were not any significant quality or bias concerns. CONCLUSIONS Both endoscopic and MIS techniques are safe and effective methods for treating patients with symptomatic lumbar stenosis. Patients who undergo endoscopic surgery seem to report less postoperative low-back pain and significantly reduced hospital stay with a trend toward less perioperative blood loss. Future large prospective randomized trials are needed to confirm the findings in this study.

scholarly journals Erector Spinae Plane Block for Lumbar Spinal Surgery: A Systematic Review

2020 ◽  
Vol Volume 13 ◽  
pp. 1611-1619
Author(s):  
Yong Qiu ◽  
Teng-Jiao Zhang ◽  
Zhen Hua
Keyword(s):  
Systematic Review ◽  
Spinal Surgery ◽  
Erector Spinae ◽  
Erector Spinae Plane Block ◽  
Lumbar Spinal Surgery ◽  
Lumbar Spinal

scholarly journals Outcome of non-instrumented lumbar spinal surgery in obese patients: a systematic review

2021 ◽  
pp. 1-9
Author(s):  
Julian Ghobrial ◽  
Pravesh Gadjradj ◽  
Biswadjiet Harhangi ◽  
Ruben Dammers ◽  
Carmen Vleggeert-Lankamp
Keyword(s):  
Systematic Review ◽  
Spinal Surgery ◽  
Obese Patients ◽  
Lumbar Spinal Surgery ◽  
Lumbar Spinal

scholarly journals Clinical Outcomes Associated With Allogeneic Red Blood Cell Transfusions in Spinal Surgery: A Systematic Review

2018 ◽  
Vol 9 (4) ◽  
pp. 434-445 ◽  
Author(s):  
Collin W. Blackburn ◽  
Katherine L. Morrow ◽  
Joseph E. Tanenbaum ◽  
Jessica E. DeCaro ◽  
Judith M. Gron ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Cell ◽  
Clinical Outcomes ◽  
Red Blood Cell ◽  
Spinal Surgery ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Research Activity ◽  
Level Of Evidence ◽  
Prolonged Length

Study Design: Systematic review. Objectives: The objectives of this systematic review were to report the available clinical evidence on patient outcomes associated with perioperative allogeneic red blood cell (RBC) transfusions in adult patients undergoing spinal surgery and to determine whether there is any evidence to support an association between transfusion timing and clinical outcomes. Methods: A systematic review of the PubMed, EMBASE, and Cochrane Library databases was performed to identify all articles examining outcomes of adult spinal surgery patients who received perioperative allogeneic RBC transfusions. The level of evidence for each study was assessed using the “Oxford Levels of Evidence 2” classification system. Meta-analysis was not performed due to the heterogeneity of reports. Results: A total of 2759 unique citations were identified and 76 studies underwent full-text review. Thirty-four studies were selected for analysis. All the studies, except one, were retrospective. Eleven studies investigated intraoperative or postoperative transfusions. Only one article compared outcomes related to intraoperative versus postoperative transfusions. Conclusions: Perioperative transfusion is associated with increased rates of postoperative complications, especially infectious complications, and prolonged length of stay. Some evidence suggests that a dose-response relationship may exist between morbid events and the number of RBC units administered, but these findings are inconsistent. Because of the heterogeneity of reports and inconsistent findings, the incidence of specific complications remains unclear. Limited research activity has focused on intraoperative versus postoperative transfusions, or the effect of transfusion on functional outcomes of spine surgery patients. Further research is warranted to address these clinical issues.

Sign in / Sign up

Export Citation Format

Share Document