Comparative Study Of Outcomes Research Articles

Spinal Accessory to Suprascapular Nerve Transfer in Traumatic Brachial Plexus Injury: A Comparative Study of Shoulder Recovery Outcomes in Anterior versus Posterior Approach and Surgeons’ Preference

Problem statementConventionally, neural transfer of SAN to SSN for shoulder abduction in traumatic brachial plexus injury is done via the anterior approach. But important advantages of the posterior approach like the proximity of neural coaptation to the muscle to be reinnervated and negating the effects of a second injury to the suprascapular nerve have made it an alternative option. MethodologyRetrospective data was collected for a total of 30 SAN to SSN transfer patients of brachial plexus injury in two groups of 15 patients each of anterior (Group A) and posterior approach (Group B) over four years. Functional outcome at the shoulder was measured as muscle power and active range of motion (ROM) at 18 months and data on patients’ satisfaction levels and surgeons’ perceptions were also collected. ResultsNo statistical difference was found in the muscle strength achieved in the two groups (p-value = 0.34) but significant recovery was found in the external rotation achieved by group B (p-value = 0.02). Statistical difference was insignificant in the two groups' active ROM during abduction and external rotation. The satisfaction index of patients was 86.7% in the posterior approach compared to 68% in group A. Surgeons’ perspective showed a faster speed of suprascapular nerve exploration as perceived in the posterior approach with better visibility of supraspinatus muscle contraction, and overall surgeons’ preference for a posterior approach. ConclusionExternal rotation at the shoulder is better with the posterior approach but no difference in abduction. Patients with the posterior approach were more satisfied with the recovery, and surgeons preferred the posterior approach.

A Comparative Study of Outcomes of Submucosal Diathermy Versus Inferior Turbinoplasty in Patients With Deviated Nasal Septum With Inferior Turbinate Hypertrophy

A Comparative Study of Outcomes of Submucosal Diathermy Versus Inferior Turbinoplasty in Patients With Deviated Nasal Septum With Inferior Turbinate Hypertrophy

A Comparative Study of the Biliary Outcome in Roux-en-Y Hepaticojejunostomy versus Duct to Duct Biliary Anastomosis in Right Lobe Living Donor Liver Transplantation in Adults

Abstract Background Recently, liver transplantation settled to be a real breakthrough in surgery as the only curable treatment to deal with fatal liver diseases. Living donor liver transplantation (LDLT) is the only available option in Egypt owing to the inactive deceased donor program. Most of the patients indicated for LDLT do not have the luxury of having an ideal living donor although we have big families in Egypt. Surgeons of recipient’s operation should occupy refined surgical skills and experience to reduce the risk of complications. The incidence of biliary complications (BCs) ranges from 5.3% to 40.6%. Leaks occur in 0% to 21.9% while strictures occur in 3.7% to 25.3%. Duct-to-duct anastomosis (D2D) and hepaticojejunostomy (HJ) are the two most common techniques of bile duct anastomosis in LDLT. D2D is gaining popularity over HJ, because of shorter operative time, fewer septic complications, a better physiologic gastrointestinal function and rapid recovery beside easier endoscopic approach to the reconstructed biliary tract. Patients and Methods The current surgical methodology is a prospective study with nonrandomized convenient sampling that was conducted at Liver Transplantation Unit in Air Forces Specialized Hospital and Nasser Institute for Research and Treatment, Cairo, Egypt, between August 2019 to August 2021. During this study, 40 patients candidate for LDLT was divided into two groups according to type of biliary anastomosis, group A included 20 recipients who had stentless duct-to-duct biliary anastomosis compared to group B including 20 recipients underwent Roux-en-Y hepaticojejunostmy. Results A total of 40 recipients were divided into two equal groups according to biliary reocstruction into group A duct-to-duct biliary anastomosis, and group B Roux-en-Y hepaticojejunostmy. The incidence of biliary related complications was higher in group A reaching 30%, double that recorded in group B (15%, p = 0.262). Upon stratification of those complications, the incidence of biliary leakage was reversed being doubled in group B 10% versus 5% in group A (p = 0.553). After exclusion of seven mortalities (one in group A and 6 in group B) who did not complete the 6 months follow-up period necessary for complete observation of BAS, there was insignificant difference between the two groups. The overall mortality was 17.5% (7 out of 8 recipients), and all died from non-biliary complication related causes. The only recipient died from biliary sepsis following ERCP and stenting for BAS, was included in the results as he died after 5 months from the operation. In a trial to understand the relation between the biliary reconstruction and the complication rate (Table 8), we found that there was a higher frequency of complications in both 1x1 and 2x2 technique in group A (33% each). In contrast, all complication happened in group B was in 1x1 technique. In addition, we could not apply the statement that the higher the number of ducts the higher the rate of complications in the study as 2 ducts grafts represent 66.7% of complications in group A compared to 100% in single duct graft in group B. Conclusion BC is a bottleneck along the path of a successful LDLT as it is multifactorial making it impossible to specify a single predictable risk factor to avoid. The advantages of D2D over HJ; especially the beneficial use of ERCP in management of complications, are buffered by the higher incidence of biliary complication that is involved with D2D. Therefore, we think that surgeons should master both reconstruction techniques and weight the risk-and-benefit case by case.

Nd:YAG Laser Capsulotomy vs. Needle Aspiration in Intumescent Cataracts: A Comparative Study of Complications and Outcomes.

The aim of this study is to compare the complications and postoperative outcomes of Nd:YAG laser anterior capsulotomy versus a needle aspiration approach for capsulorhexis in patients with intumescent cataracts. University of Health Sciences, Basaksehir Cam and Sakura City Hospital department of Ophthalmology, Istanbul, Turkey. Retrospective, cross-sectional study. Intumescent cataract patients were divided into two groups. Group 1 (37 eyes) underwent Nd:YAG Laser capsulotomy pre-surgery, which reduced lens pressure. In group 2 (31 eyes), the capsulorhexis was completed by reducing the intralenticular pressure by needle aspiration and then gradually expanding the capsule. Demographics, pre/post-op parameters, complications, and surgical times were analyzed. Evaluated were 68 eyes from 68 patients. Age and gender exhibited no significant differences between groups. Group 2 had more complications than Group 1 (p=0.041). Specifically, no capsular tear extensions were seen in Group 1, while four patients in Group 2 had tears extending to the lens periphery. Group 1 showed a significant decrease in surgical maneuvers and time (p=0.028), while no significant difference was found in effective phacoemulsification time (p=0.076). Nd: YAG laser capsulotomy effectively prevented capsular extensions and reduced surgical time in intumescent cataracts. This technique provides a safe alternative to traditional methods, potentially reducing intraoperative risks and improving surgical efficiency. The findings support Nd: YAG laser anterior capsulotomy as a viable approach for capsulorhexis in intumescent cataracts, emphasizing its potential benefits in reducing complications and enhancing surgical outcomes.

Abdominoplasty versus endoscopic approach to diastasis recti repair: a comparative study of outcomes.

Diastasis recti (DR) is characterized by deviation of the abdominal rectus muscle due to widening of the linea alba and laxity of the abdominal wall musculature1,2. This condition affects quality of life, in terms of performance of activities of daily living (ADL) and physical tasks3-7. Several techniques have been described to correct DR11. This prospective research aimed at comparing the traditional approaches versus endoscopic plication for rectus diastasis repair in terms of safety, effectiveness and satisfaction of the patients based on PROMs (Patients Reported Outcome Measures) through BODY-Q abdomen scale. Materials and Methods. We performed a retrospective multicenter study in two departments of aesthetic and plastic surgery (Department of Plastic Surgery, San Carlo of Nancy Hospital, Rome [group I] and Hospital Británico de Buenos Aires, Argentina [group II]). A total of 85 consecutive patients treated with abdominoplasty access (group I) and 85 consecutive patients treated with an endoscopic approach (group II) were enrolled in the study. The minimum follow up was 12 months. Results Descriptive statistics were used to report counts and frequencies for categorical data. Continuous normally and non-normally distributed data were described as means with standard deviations (SD) and medians with interquartile ranges (IQR) as appropriate. All analyses were performed using STATA/IC 16.0 (StataCorp LLC; College Station, TX). Conclusion Our multicenter experience reveals that both open and minimally invasive approaches are viable options. Identifying the optimal approach for diastasis recti repair should rely also on the patient's desired treatment outcome.

Direct healthcare costs in the first 2 years of life: A comparison of screened and clinically diagnosed children with cystic fibrosis – The Irish comparative outcomes study of CF (ICOS)

BackgroundIn July 2011, Cystic Fibrosis (CF) was added to the Newborn Bloodspot Screening Programme in Ireland. The Irish Comparative Outcomes Study (ICOS) is a historical cohort study established to compare outcomes between clinically-detected and screen-detected children with CF. Here we present the results of economic analysis comparing direct healthcare costs in the first 2 years of life of children born between mid-2008 and mid-2016, in the pre-CF transmembrane conductance regulator modulator era. MethodsHealthcare resource use information was obtained from Cystic Fibrosis Registry of Ireland (CFRI), medical records and parental questionnaire. Hospital admissions, emergency department visits, outpatient appointments, antibiotics and maintenance medications were included. Costs were estimated using the Health Service Executive Casemix, Irish Medicines Formulary and hospital pharmacy data, adjusted for inflation using Consumer Price Index data from the Central Statistics Office. A Negative Binomial regression was used, with time in the study as an offset. ResultsOverall participation was 93 %. After exclusion of those with meconium ileus, data from 139 patients, with follow-up to 2 years of age, were available. 72 (51.8 %) were from the clinically diagnosed cohort. In the final model (n=105), clinically diagnosed children had 2.62-fold higher costs per annum (p<0.0001), when adjusted for confounders, including homozygous ΔF508 or G511D mutation, socio-demographic factors and time between diagnosis and first CFRI interaction. ConclusionsThere are few studies evaluating economic aspects of newborn screening for CF using routine care data. These results imply that the benefits of newborn screening extend to direct healthcare costs borne by the State.

A Comparative Study of Maternal and Foetal Outcome between Reversed Breech Extraction Technique and Foetal Pillow, During Caesarean Section in Full Dilatation (CSFD), In Second Stage of Labour

A Comparative Study of Maternal and Foetal Outcome between Reversed Breech Extraction Technique and Foetal Pillow, During Caesarean Section in Full Dilatation (CSFD), In Second Stage of Labour

Traditional Hands-On Puzzle Method versus Fully Digital Approach in Teaching Tooth Morphology: A Comparative Study of Educational Outcomes.

Tooth morphology education is a critical component of dental curricula, providing a foundational understanding of the intricate structural anatomy of teeth. This study evaluates the learning outcomes in relation to tooth morphology of two student cohorts from different academic terms, comparing the traditional 'tooth puzzle' method to an alternative fully digital approach. Two groups of Master of Dentistry students were retrospectively analyzed. The control group (55 students) was taught via the 'tooth puzzle' method in 2021, while the experimental group (55 students) underwent a fully digital course in 2020 due to COVID-19 restrictions. Both groups completed a digital examination involving the identification of 40 teeth, presented as images and videos. In the control group of 55 students, nearly half (49.1%) achieved faultless results, while 65.5% had at most two faults, and 74.5% had no more than four faults. The group had a total of 163 faults, averaging 3.0 per student, with only one student (1.8%) failing the test. In stark contrast, the experimental group had no students without faults, 9.1% had four or fewer faults, and a significant 61.8% made 10 or more faults, with 29.1% failing their first test attempt by exceeding 12 faults. Overall, the experimental group registered 582 faults, averaging 10.6 per student. The 'tooth puzzle' method, with its interactive and tactile elements, proved more effective in teaching tooth morphology than the digital-only approach. The increased number of faults and failed tests in the experimental group suggest that while digital tools offer meaningful support in learning tooth morphology, their main advantage is seen when coupled with traditional hands-on techniques, not unassisted and independently.

A comparative study on outcome of endonasal dacryocystorhinostomy with and without silicone intubation-otorhinolaryngology

Background: Epiphora or “tearing eye” is a functionally and socially, bothersome symptom. Dacryocystitis is an inflammatory condition of the nasolacrimal sac caused due to an obstruction within the nasolacrimal duct (NLD). Dacryocystitis can be classified as acute and chronic or acquired and congenital. Chronic dacryocystitis is almost always managed surgically. The present study was undertaken for comparative study of outcomes of endonasal Dacryocystorhinostomy (DCR) done with and without silicone intubation. Methods: The 50 cases dacryocystitis were selected. The patients were divided in group A cases (with intubation) and group B controls (without intubation) randomly. A detailed history was taken followed by general physical and clinical otorhinolaryngological examination. Patients were evaluated with nasal endoscopy, DCG (Dacrocystogram), through which site of obstruction was located. Results: In our study, Among the cases 18 subject presented with right dacryocystitis and 7 with left dacryocystitis. Similarly, among the controls, 20 subjects presented with right dacryocystitis and 5 presented with left dacryocystitis. According to modified Likert’s score, at the end of 6 months when a nasal endoscopy was done along with syringing 96% of the cases had patent rhinostomy while only 80% of the controls showed patency. Post operative epistaxis was evident in 6 cases and 4 controls. Conclusions: Endonasal DCR with and without stenting, had more or less similar results, with equal post op complications. Though, with stenting, success rates were high as shown in our study.

A Comparative Study of Functional Outcomes in Unstable Pelvic Ring Fractures Treated With Internal Fixator (INFIX) With and Without Sacroiliac Joint Screw Fixation.

Introduction Despite constituting only 3-8% of orthopedic trauma cases, pelvic injuries are associated with high mortality rates, emphasizing the critical need for stable fixation rather than merely anatomical alignment. The use of an anterior, subcutaneous, internal pelvic fixator (INFIX), a novel technique, has shown promise in treating these injuries. Posterior pelvic ring injuries are challenging because they require a significant level of surgical training and technical expertise, and each treatment method has disadvantages. The aim of this study is to compare the clinical and biomechanical outcomes of INFIX with and without sacroiliac screw fixation for unstable pelvic fractures. Methods and methodology Retrospectively, we selected 20 patients with unstable pelvic ring injuries who had come to a high-volume tertiary care hospital and medical college in the state of Maharashtra, India. All the patients were operated on with INFIX; 10 with a sacroiliac joint screw and 10 without a sacroiliac joint screw. We followed up with the patients for six months and evaluated them according to the Majeed score. Results Functional outcomesdiffered little between INFIX patients operated on with and without a sacroiliac joint screw. However, morbidity, hospital stay, the need for ICU, radiation exposure, and technical ease of surgery were improved in INFIX patients without the sacroiliac screw procedure. We noted an average Majeed score of 78 in the INFIX-alone group and 77.2 in the group that received INFIX with a sacroiliac joint screw. Six months after the surgery, the patients showed signs of a stable bony union, had achieved a full range of motion, and reported no problems in their day-to-day work. Conclusion Although this was a short-term study, we conclude that INFIX without a sacroiliac joint screw showed a comparable functional outcome compared to INFIX with a sacroiliac joint screw. Patients with INFIX alone showed better results; they had reduced surgical time, reduced radiation exposure, and less evidence of neurological harm to the L5-S1 nerve root. The procedure was less complicated and easier for surgeons to learn. Its simplicity and speed were especially beneficial for obese patients.

PlasmaBlade versus Electrocautery for Deep Inferior Epigastric Perforator Flap Harvesting in Autologous Breast Reconstruction: A Comparative Clinical Outcome Study.

(1) Background: DIEP-based breast reconstruction necessitates wide undermining at the abdominal donor site, creating large wound areas. Flap harvesting is usually conducted using electrosurgical dissection devices. This study sought to compare the clinical outcomes in patients after using the PEAK PlasmaBlade (PPB) versus monopolar electrocautery (MPE). (2) Methods: This retrospective cohort study included 128 patients with DIEP-based breast reconstruction. Patient characteristics and information on the postoperative course were collected and a comparative evaluation was conducted. (3) Results: The MPE group exhibited significantly (p* = 0.0324) higher abdominal drainage volume (351.11 ± 185.96 mL) compared to the PPB group (279.38 ± 183.38 mL). A subgroup analysis demonstrated that PPB significantly reduced postoperative wound fluid in patients with BMI > 30 kg/m2 (p* = 0.0284), without prior neoadjuvant chemotherapy (p** = 0.0041), and among non-smokers (p = 0.0046). Furthermore, postoperative pain was significantly (p**** < 0.0001) lower in the PPB cohort. (4) Conclusions: This study confirms the non-inferiority of the PEAK PlasmaBlade to conventional electrocautery for abdominal flap harvesting. The PPB demonstrated advantages, notably reduced drainage volume and lower postoperative pain levels. Recognizing patient subsets that benefit more from the PPB highlights the importance of personalized device selection based on patient characteristics.

A Comparative Study of Endoscopic Septoplasty and Conventional Septoplasty Outcomes

A Comparative Study of Endoscopic Septoplasty and Conventional Septoplasty Outcomes

Comparative Study of Fetomaternal Outcome in Abruptio Placenta and Placenta Previa

Background: Abruptio placenta and placenta previa are obstetric complications associated with significant risks for both the fetus and the mother, potentially leading to severe hemorrhage, preterm birth, and maternal shock. Early detection and prompt medical intervention are crucial for optimizing outcomes and reducing maternal and fetal morbidity and mortality.&#x0D; Objective: The study aims to analyze the maternal and perinatal outcomes of APH cases due to placenta previa and abruptio placenta.&#x0D; Methods: This prospective study conducted at Ad Din Akij Medical College, Boyra, Khulna July 1, 2021, to June 30, 2023, included 150 APH cases, with 109 meeting inclusion criteria for comparison between placenta previa and abruptio placenta. Data collection encompassed maternal demographics, obstetric history, severity of hemorrhage, and neonatal outcomes. Diagnosis was based on clinical evaluation and ultrasound. Statistical analysis was performed using MS Excel.&#x0D; Results: In our Study, the distribution of causes of placental issues reveals that Placenta Previa accounts for the majority, comprising 71.55% of cases, while Abruptio Placentae represents 28.44% of instances. Placenta Previa predominantly affects individuals aged 26-30 years and over 35 years, with the highest occurrence among those with 2 pregnancies. Conversely, Abruptio Placentae shows a varied distribution across age groups, with the highest incidence among those aged 31-35 years and with gravidity of 1 pregnancy. Gestationally, the majority of Abruptio Placentae cases present between 31-33 weeks, while Placenta Previa cases peak at 34-36.6 weeks. Preterm births are prevalent in both conditions, with Placenta Previa leading in preterm deliveries. Placenta Previa is associated with a history of abortion and dilation and curettage (D&amp;C), while hypertension is a significant risk factor for Abruptio Placentae. Maternal complications include anemia, postpartum hemorrhage (PPH), and shock, with Placenta Previa being associated with anemia and PPH, while Abruptio Placentae correlated with shock.&#x0D; Conclusion: Placenta previa emerged as the primary cause of APH, affecting multiparous women, while abruptio placenta correlated with hypertension and primigravida. Both conditions posed significant risks of maternal and perinatal morbidity and mortality, highlighting the importance of prompt diagnosis and intervention.

A Comparative Study of Functional Outcome Following Philos Plating Versus Percutaneous Pinning in Proximal Humerus Fractures

A Comparative Study of Functional Outcome Following Philos Plating Versus Percutaneous Pinning in Proximal Humerus Fractures

Comparative study of feto-maternal outcome during 1st and 2nd wave of COVID-19 in department of obstetrics and gynaecology at a tertiary health care centre, South Gujarat

Comparative study of feto-maternal outcome during 1st and 2nd wave of COVID-19 in department of obstetrics and gynaecology at a tertiary health care centre, South Gujarat

A Comparative Study of Clinical Outcomes in Locally Advanced Cervical Cancer: External Beam Radiotherapy (EBRT) and Sequential High Dose Rate Intracavitary Brachytherapy (HDRICBT) with or without Concurrent Cisplatin on the Day of ICBT Insertion - A Tertiary Care Center Randomized Controlled Trial in India.

The current study aimed to delve into the comparative clinical outcomes between external beam radiation therapy (EBRT) and sequential High Dose Rate Intracavitary Brachytherapy (HDRICBT) with or without concurrent cisplatin administration on the day of intracavitary brachytherapy (ICBT) insertion in women with locally advanced cervical cancer. In this study, conducted between January 2017 and July 2018 at a leading institute in India, diagnosed and untreated patients of locally advanced carcinoma cervix were randomized into two groups. Arm 1 received concurrent cisplatin before each course of brachytherapy, while Arm 2 underwent brachytherapy alone. The outcomes were compared in terms of acute and late toxicities, treatment response, and follow-up. Data analysis was performed using SPSS 16, with statistical significance set at p < 0.05. Both study arms showed similar complete response (CR) rates of 73.3%, with no significant advantage of concurrent cisplatin before brachytherapy. However, a noteworthy trend emerged during follow-up. In the concurrent cisplatin group, the CR rate increased from 73.3% post 1 month of brachytherapy to 86.7% at 3 months and 83.3% at 6 months. Contrastingly, the control group showed CR rates of 73.3% post 1 month, 80% at 3 months, and 76.6% at 6 months. While not statistically significant, this observation suggests a possible enhancement in response rates with concurrent cisplatin and ICBT. Future studies focusing on the optimal drug, dosage, scheduling, and combining cisplatin with other agents are recommended to further explore the potential benefits observed in this study.

Comparative Effectiveness of Partial Gland Cryoablation Versus Robotic Radical Prostatectomy for Cancer Control

Background and objectiveThere is an absence of high-level evidence comparing oncologic endpoints for partial gland ablation, and most series used prostate-specific antigen (PSA) rather than biopsy endpoints. Our aim was to compare oncologic outcomes between partial gland cryoablation (PGC) and radical prostatectomy (RP) for prostate cancer. MethodsThis was a retrospective, single-center analysis of subjects treated with PGC (n = 98) or RP (n = 536) between January 2017 and December 2022 as primary treatment for intermediate-risk (Gleason grade group [GG] 2–3) prostate cancer. Oncologic endpoints included protocol surveillance biopsies after PGC in comparison to serial PSA testing after RP. The primary outcome was treatment failure, defined as a need for any salvage treatment or development of metastatic disease. Treatment failure and survival analyses were conducted using Cox proportional-hazard regression and Kaplan Meier survival curves. Key findings and limitationsAfter applying the inclusion/exclusion criteria, the PGC (n = 75) and RP (n = 298) groups were compared. PGC patients were significantly older (71 vs 64 yr; p < 0.001) but there were no differences in PSA, biopsy GG, or treatment year between the groups. The PGC group had higher rates of treatment failures at 24 mo (33% vs 11%; p < 0.001) and 48 mo (43% vs 14%; p < 0.001). One PGC patient (2.1%) and one RP patient (0.7%) had developed metastases by 48-mo follow-up (p = 0.4). On adjusted analysis, PGC was associated with a higher risk of treatment failure (hazard ratio 4.6, 95% confidence interval 2.7–7.9; p < 0.001). Limitations include observational biases associated with the retrospective study design. ConclusionsThis is the first comparative effectiveness study of cancer control outcomes for PGC versus RP. The results demonstrate an almost fivefold higher risk of treatment failure with PGC during short-term follow-up. Patient summaryWe compared cancer control outcomes for patients with intermediate-risk prostate cancer treated with partial prostate gland cryoablation versus radical prostatectomy. We found that partial gland cryoablation had an almost fivefold higher risk of treatment failure. Men with prostate cancer should be counseled regarding this difference in treatment failure.

‘’Comparative outcome study between simple closure and flap technique in Pilonidal sinus disease’’

I have read the interesting article ‘’Comparative outcome study between simple closure and flap technique in Pilonidal sinus disease’’ by Dr. Ram Magar and Dr. Rupali Magar published in your journal on 15th March 2022. According to this valuable study; Limberg flap method has has been found to have better outcome with less wound infection, wound disruption, postoperative discharge and recurrence rate compared to simple closure group. And as stated, it is safe and easy procedure. So it is recommended that Limberg flap method should be used in the treatment of pilonidal sinus disease over other modalities.[1]&#x0D; In our 767 patients study group results, we had recommended Limberg Flap Repair Technique for surgical treatment of pilonidal sinus disease. This technique had an acceptable “short” ‘Return to Work Outcome’ when compared with open techniques. Also had the smallest postoperative infection rate and low recurrence rate.&#x0D; Still in our daily surgical practice, earlier healing, shorter return to work, lower rates of infection and recurrence are the major factors that make us to use Limberg Flap Repair Technique mostly. Moreover, it is easy, fast, and practical to apply.[2]

Comparative study of percutaneous transfacet screw and pedicle screw in oblique lumbar interbody fusion for the treatment of single-level lumbar spinal stenosis

Objective: To conduct a comparative study of radiological and clinical outcomes between percutaneous transfacet screw (TFS) and pedicle screw (BPS) in oblique lateral lumbar interbody fusion (OLIF) for single-level lumbar spinal stenosis. Methods: A retrospective cohort study. Patients who underwent OLIF with TFS or BPS for the treatment of single-level lumbar spinal stenosis at Beijing Jishuitan Hospital from January 2019 to June 2022 were retrospectively analyzed. Radiological parameters and clinical indicators were compared between the two groups. Radiological parameters included preoperative, immediate postoperative (within 5 days), and 1-year postoperative measurements of disc height and segmental lordosis angle, as well as interbody fusion status at 1 year postoperatively. Clinical indicators included operative time, blood loss, length of hospital stay, complications, and Oswestry Disability Index (ODI), visual analogue scale (VAS) scores for back pain, and leg pain before and 1 year after surgery. Results: Four male and 10 female patients with an average age of (61.0±11.2) years underwent OLIF with TFS, while 9 male and 12 female patients underwent OLIF with BPS, with a mean age of (60.9±6.7) years. There was no statistically significant difference in preoperative disc height between the TFS and BPS groups (P>0.05). The immediate postoperative disc height was (12.9±2.1) mm and it was (10.4±1.7) mm at 1-year follow-up in the TFS group; in the BPS group, it was (12.9±2.1) mm immediately postoperatively and (11.9±2.1) mm at 1-year follow-up; there was statistically significant difference between the two groups at 1-year follow-up (P=0.037). The segmental lordosis angle showed no significant differences within each group or between the two groups at preoperative, immediate postoperative, or 1-year postoperative follow-up (all P>0.05). At 1-year postoperative follow-up, the fusion rates was 92.9%(13/14) in the TFS group and 95.2%(20/21) in the BPS group, with no statistically significant difference between the two groups (P>0.05). The TFS group had a significantly shorter operative time and less blood loss compared to the BPS group [(164.3±33.9) minutes vs (191.7±31.8) minutes and (74.3±46.9) ml vs (124.8±54.0) ml, respectively] (both P<0.05). Both groups showed significant improvement in ODI and VAS scores at 1 year postoperatively compared to those preoperatively, but with no statistically significant difference was found between the groups (both P>0.05). Conclusions: OLIF with TFS fixation can effectively restore disc height and alleviate back and leg pain in patients with single-level lumbar spinal stenosis. Compared to the OLIF with BPS procedure, OLIF with TFS has shorter operative time and less blood loss.

Synchronous versus metachronous spinal metastasis: a comparative study of survival outcomes following neurosurgical treatment

PurposePatients with spinal metastases (SM) from solid neoplasms typically exhibit progression to an advanced cancer stage. Such metastases can either develop concurrently with an existing cancer diagnosis (termed metachronous SM) or emerge as the initial indication of an undiagnosed malignancy (referred to as synchronous SM). The present study investigates the prognostic implications of synchronous compared to metachronous SM following surgical resection.MethodsFrom 2015 to 2020, a total of 211 individuals underwent surgical intervention for SM at our neuro-oncology facility. We conducted a survival analysis starting from the date of the neurosurgical procedure, comparing those diagnosed with synchronous SM against those with metachronous SM.ResultsThe predominant primary tumor types included lung cancer (23%), prostate cancer (21%), and breast cancer (11.3%). Of the participants, 97 (46%) had synchronous SM, while 114 (54%) had metachronous SM. The median overall survival post-surgery for those with synchronous SM was 13.5 months (95% confidence interval (CI) 6.1–15.8) compared to 13 months (95% CI 7.7–14.2) for those with metachronous SM (p = 0.74).ConclusionsOur findings suggest that the timing of SM diagnosis (synchronous versus metachronous) does not significantly affect survival outcomes following neurosurgical treatment for SM. These results support the consideration of neurosurgical procedures regardless of the temporal pattern of SM manifestation.