Background:The new emerging application of decompression combined with fusion comes with a concern of cost performance, however, it is a lack of big data support. We aimed to evaluate the necessity or not of the addition of fusion for decompression in patients with lumbar degenerative spondylolisthesis.Methods:Potential studies were selected from PubMed, Web of Science, and Cochrane Library, and gray relevant studies were manually searched. We set the searching time spanning from the creating date of electronic engines to August 2020. STATA version 11.0 was exerted to process the pooled data.Results:Six RCTs were included in this study. A total of 650 patients were divided into 275 in the decompression group and 375 in the fusion group. No statistic differences were found in the visual analog scales (VAS) score for low back pain (weighted mean difference [WMD], –0.045; 95% confidence interval [CI], –1.259–1.169; P = .942) and leg pain (WMD, 0.075; 95% CI, –1.201–1.35; P = .908), Oswestry Disability Index (ODI) score (WMD, 1.489; 95% CI, –7.232–10.211; P = .738), European Quality of Life-5 Dimensions (EQ-5D) score (WMD, 0.03; 95% CI, –0.05–0.12; P = .43), Odom classification (OR, 0.353; 95% CI 0.113–1.099; P = .072), postoperative complications (OR, 0.437; 95% CI, 0.065–2.949; P = .395), secondary operation (OR, 2.541; 95% CI 0.897–7.198; P = .079), and postoperative degenerative spondylolisthesis (OR = 8.59, P = .27). Subgroup analysis of VAS score on low back pain (OR = 0.77, 95% CI, 0.36–1.65; P = .50) was demonstrated as no significant difference as well.Conclusion:The overall efficacy of the decompression combined with fusion is not revealed to be superior to decompression alone. At the same time, more evidence-based performance is needed to supplement this opinion. 相似文献
Aims: To describe the results of orbital decompression in patients with spontaneous globe luxations and to evaluate predisposing factors for this condition.
Methods: The clinical records of patients who underwent orbital decompression for the treatment of spontaneous globe luxations between 2010 and 2013 were reviewed. Data collected were age, gender, predisposing factors, preoperative and postoperative exophthalmometry, duration of follow-up, presence of diplopia before and after surgery and intra- and postoperative complications.
Results: Seven patients underwent orbital decompression after spontaneous globe luxation during the study period. Six patients underwent bilateral decompression. Two patients underwent a three-wall decompression, four of them medial and lateral decompression and one patient medial decompression. The predisposing factors for globe luxation were Graves’ orbitopathy, malar hypoplasia, high myopia, floppy eyelid syndrome and orbital fat hypertrophy in the context of obesity. After orbital decompression, none of the patients reported new globe luxations. No intraoperative complications were observed. None of the patients developed de novo diplopia.
Discussion: Orbital decompression is an effective method for the prevention of new episodes in patients with spontaneous globe luxations. It has good aesthetic and functional results and addresses the exophthalmos present in most cases. 相似文献
BackgroundOrbital compartment syndrome (OCS) is an ocular emergency that can severely threaten the visual potential. The most common etiologies include facial trauma-related orbital wall fractures and postoperative bleeding within the orbit. Nontraumatic cases were also reported sporadically, although they are rare. The orbital volume limits the compliance to expand when space-occupying lesions develop. Both direct compression of the optic nerve and depleted perfusion from elevated intraorbital pressure subsequently lead to ischemic optic neuropathy and vision loss.Case ReportA 74-year-old man experienced headache, bulging left eye, dull pain, vision loss, nausea, and vomiting within 1 day. Computed tomography and magnetic resonance imaging revealed a heterogeneous mass extending from the orbital apex and connected with the ophthalmic vein. Lateral canthotomy and cantholysis were performed at bedside for emergent orbital decompression. The proptosis and pain relieved after surgery, but visual loss remained irreversible. Surgical exploration was conducted and pathology proved the diagnosis of varix of the ophthalmic vein with thrombosis.Why Should an Emergency Physician Be Aware of This?Clinicians should be aware of the presentation of OCS and perform timely orbital decompression, which could reverse visual impairment. These patients might also benefit from immediate consultants with ophthalmologists and radiologists. 相似文献